Role Description The Senior Specialist, Issue Management supports the design, optimization, and implementation of processes and improvements to provider operations in support of achieving organizational goals. The Senior Specialist is responsible for day-to-day oversight of our most critical bottlenecks in Operations being resolved. The lead will implement lean, repeatable, and scalable tools and techniques and independently represent the team within the broader organization. You will report into the Director, Process Improvement. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities - With support from leadership, help identify risks; respond to and resolve issues/errors/escalations through investigation to inform insights for short/medium/long-term technology-enabled processes and solutions. - Coordinate projects and processes to help ensure key milestones and service levels are met. - Partner with leadership to strategize, implement, and manage arrangements aimed at lowering overall cost or improving outcomes. - Partner with cross-functional teams to ensure action plans align with continuous improvement goals, and participate in collaboration with peers and cross-functional stakeholders. - Support the management, stewardship, and analysis of data to support compliant and performant business operations. - Provide recommendations that ensure financial discipline and quality. - Support identifying and implementing process improvement initiatives, as well as mindset shifts, to optimize operational efficiency and achieve performance targets. - Compliance with all applicable laws and regulations. - Other duties as assigned. Qualifications - 1+ years of professional experience in payer or provider operations, provider network management, healthcare operations, or a related field. - 1+ years of experience using data and metrics to drive improvements. - 1+ years of experience in process improvement and workflow design. - 1+ years of experience in developing and presenting information and recommendations aimed at Senior Leadership. Bonus Points - ACA marketplace, provider network, claims, healthcare quality, or provider data experience. - Management consulting experience. - Training or experience applying Continuous Process Improvement or Lean Six Sigma principles. - Experience with project coordination or management in a matrixed organization. - Experience supporting RFP development and implementation of software or service solutions. Benefits - Medical, dental, and vision benefits. - 11 paid holidays. - Paid sick time. - Paid parental leave. - 401(k) plan participation. - Life and disability insurance. - Paid wellness time and reimbursements.

• Work with insurance companies to obtain medication approvals. • Use pharmacy systems to enter data, run test claims, and manage follow-up actions. • Document patient needs, authorization status, and assistance efforts across systems and EMRs. • Communicate with prescribers to ensure accurate and appropriate prescriptions. • Maintain detailed records of all patient interactions. • Assist patients with insurance claims and medication adherence over the phone. • Partner with pharmacists and liaisons to support coordinated patient care. • Research information to support decisions and operational improvements. • Manage and update data in relevant databases. • Identify issues, recommend solutions, and participate in process improvement initiatives. • Maintain confidentiality and ongoing professional development. • Perform additional duties as needed; minimal travel may be required.

Role Description Molina Healthcare is hiring for remote Certified Pharmacy Technicians. These roles will be in our Prior Authorization department. You will review prior auth requests that are submitted. Shift times for these roles will be: - Monday through Friday 12:30-9pm MST - Tuesday through Saturday 9am-5:30pm MST The training schedule will be approximately 7 weeks 9am-5:30pm MST. As a Pharmacy Tech here at Molina, you will provide support for pharmacy technician activities and contribute to overarching pharmacy strategy for optimization of medication-related health care outcomes and quality cost-effective member care. Essential Job Duties - Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests. - Accurately enters approvals or denials of requests. - Facilitates prior authorization requests within established pharmacy policies and procedures. - Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices. - Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership. - Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues. - Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff, and others as needed. Qualifications - At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience. - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Ability to abide by Molina policies. - Ability to maintain attendance to support required quality and quantity of work. - Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA). - Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers. - Excellent verbal and written communication skills. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. Benefits - Molina Healthcare offers competitive benefits and compensation package. Company Description - Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Role Description As a member of our in-house clinical team, you will be critical to this mission. You will be joining our small team of prescribers to achieve our goal of making healthcare accessible, convenient and safe. - Conduct asynchronous text-based consultations with patients through our bespoke telehealth platform, to assess and prescribe weight-loss medications. - Provide outstanding medical advice to patients, creating lasting impressions due to its depth and personalisation. - Demonstrate knowledge and awareness relevant to the areas we prescribe (primarily GLP-1/GIP agonist medications). - Adhere to our practice standards, quality and safety procedures and policies, and complete all required training. - Triage medical enquiries efficiently to ensure excellent patient safety and care is received. - Respond to medical incidents promptly as escalated, via phone or asynchronous messaging. - Be a critical point of contact for our Eucalyptus-partnered clinicians and work closely with a team of healthcare professionals to assist in building processes and systems that improve over time. - Assist in the creation of medical knowledge centres that empower our broader team to provide deeper and more personalised patient experiences. Qualifications - Qualified as a Pharmacist Independent Prescriber. - Current registration with the General Pharmaceutical Council (GPhC). - A high level of empathy and a passion for delivering an exceptional patient experience. - Organised, independent and can work well in a team. - Excellent attention to detail and commitment to quality. - Skilled at using technology to deliver care and communicate with patients, especially in written formats. - Experience in online prescribing. - Open to working either part-time or full-time roles. Requirements - Experience in prescribing for weight loss (bonus points). Benefits - Make real impact, fast. - Work with others who are incredibly passionate about what they do. - High talent bar and strong work ethic. - Stretch yourself every day with autonomy to tackle interesting problems.