Dane Street

Sales

• **JOB SUMMARY**
• We are seeking a Vice President of Sales to lead our growth strategy, drive net-new business, and disrupt the traditional PBM landscape. In this role, you won't just manage a pipeline—you will actively hunt, negotiate, and close high-stakes deals with consultants, brokers, employers, and health plans while further building on our existing sales/account management teams. If you are a strategic closer with a deep book of business and a passion for winning, we want you on our team.
• Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other, and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.
• **MAJOR DUTIES & RESPONSIBILITIES**
• - **Drive Aggressive Revenue Growth:** Own and execute the PBM sales strategy to consistently meet and exceed annual growth targets.
• - **Capture Market Share:** Actively target and win over accounts from legacy PBM competitors by effectively positioning our unique value proposition, transparency, and cost-savings models.
• - **Cultivate High-Value Relationships**: Leverage and expand your existing network of PBM/health plan executives and consultants to generate a robust pipeline.
• - **Lead Complex Deal Cycles**: Command the end-to-end sales process for Top 20 PBMS, mid-market and enterprise accounts, from initial prospecting and finalist presentations to complex contract negotiations and closures.
• - **Collaborate Across Teams**: Partner closely with Underwriting, Actuarial, and Legal teams to price competitively and structure winning, customized financial models (spread vs. pass-through, rebate structures, etc.).
• Other duties & special projects, as assigned and based on business needs.

Vice President of Sales – PBM, Pharmacy Benefits

Director

• **JOB SUMMARY**
• The Director of Group Health is responsible for the overall client satisfaction and growth of Dane Street’s Group Health Division.
• Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.
• **MAJOR DUTIES & RESPONSIBILITIES**
• - Ensure delivery of key client metrics including Turnaround Time (TAT), Quality (measured by clarification %), P2P success, overturn rate, and any other key performance metrics set forth by our Group Health customers.
• - Lead the Operations Management Team and oversee all activities directly related to the operational procedures.
• - Attract, recruit, and retain Team members.
• - Work with the Group Health Operations Teams on internal and external quality audits and make recommendations on process improvements/updates.
• - Recommend development initiatives to help enhance the usage of technology for client satisfaction and internal efficiencies.
• - Responsible for the reconciliation of client outcomes reports & issue logs.
• - Responsible for the overall Profit and Loss of the Group Health Division.
• - Work with the National Medical Director on the development and management of the physician panel.
• Other duties & special projects, as assigned and based on business needs.

Director of Group Health

Operations

• Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS.
• Work with the client on any information missing that is pertinent to processing the claim.
• Sort, organize, and create a medical document listing if required by the client and in accordance with specific special handling.
• Assign/schedule new cases to physicians for review with the appropriate physician based on location, reviewer availability, specific guidelines, jurisdictional requirements, and other client requirements.
• Ensure that the assigned physician has no conflict of interest with the case assignment.
• Monitor, process, and track cases to ensure we meet deadlines.
• Review reports accompanying medical records to ensure that the report is complete and that all questions posed by the client have been addressed.
• Follow up with the reviewer with any additional questions or clarification needs.
• Update clients frequently on referral progress.
• Ensure the report is grammatically correct with no spelling errors.
• Ensure each referral adheres to the QA checklist prior to the completion.
• Communicate clearly and concisely between the customer, reviewer, and Operations team.
• Must confidently speak with physicians and clients regarding the content of their IME/record reviews.
• Update clients frequently on cases in progress.
• Ensure proper documentation for specified cases is provided to the client.

Liability IME Operations Specialist

Analyst

• Managing the various aspects of the medical file review process
• Reviewing the completed referral to ensure client questions have been addressed appropriately
• Reviewing the completed report for accuracy
• Ensuring client and department standards have been met
• Conducting quality audits
• Following up with the reviewer with any additional questions or clarifications needed
• Following up with the client should there be any additional questions
• Updating clients frequently on referral progress
• Ensuring the report is grammatically correct with no spelling errors
• Ensuring each referral adheres to the QA checklist prior to completion
• Formatting reports for approval
• Communicating clearly and concisely between the customer, reviewer, and Operations team
• Confidently speaking with physicians and clients regarding the content of their peer reviews.

Peer/Record Review Quality Analyst

Manager

• The Assistant Manager supports the overall profitability and success of the Regional Operations Center by assisting with financial, operational, and team objectives.
• This role partners closely with the Operations Manager to help achieve referral and revenue goals, improve staffing efficiency, and maintain high levels of performance and client satisfaction.
• The Assistant Manager contributes to reporting, process improvement, and fostering a positive, client-focused work environment.
• Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other and Dane Street.
• It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.
• **MAJOR DUTIES & RESPONSIBILITIES**
• *Support Revenue Growth*
• - Assist in driving revenue growth by delivering excellent Customer service.
• - Help ensure scheduling best practices and turnaround time standards are followed.
• - Support timely delivery of high-quality reports.
• - Respond to and help resolve client inquiries in a timely manner.
• * Support Physician Cost Optimization*
• - Assist in ensuring client invoices align with agreed-upon fee schedules.
• - Support proper physician selection based on claimant location, specialty, and pricing requirements.
• - Help maintain and support relationships with key physicians to promote panel retention.
• Support *Staff Performance and Capacity*
• - Assist in monitoring performance metrics for Customer Service Representatives (CSR) and Quality Assurance (QA) Specialists.
• - Support efforts to meet or exceed departmental productivity and quality targets.
• - Participate in onboarding and training of new team members as staffing needs increase.
• - Assist with performance feedback and documentation as needed.
• *Client Interaction*
• - May support client visits and meetings with the Sales team, as needed.
• *Operational Support*
• - Assist with monitoring overall production, performance, and quality for the assigned region.
• - Help plan and organize daily operational activities.
• - Assist in reviewing productivity, financial, and activity reports.
• - Coordinate with support departments such as Human Resources, Finance, IT, and Business Analysis to support operational goals.
• - Help assess staffing and resource needs to meet production targets.
• - Assist in coordinating and supporting the deposition process at the request of clients or defense counsel.
• Other duties & special projects, as assigned and based on business needs.

Physician Advisory Services Assistant Manager

QA Engineer

• Oversight of the review of Physician reports and accompanying medical records to ensure completeness, accuracy, and consistency with medical evidence
• Ensure appropriate QA staff are assigned to each file and supervise staff
• Manage the File Review Board ensuring timely and accurate file processing
• Assist in identifying & correcting staff performance including promotions, discipline, coaching, and termination
• Ensure all QA staff adhere to and meet job duties
• Actively participate in issue resolution with QA, physicians, account managers, and other related parties
• Act as the liaison regarding the process or status of the file
• Other duties & special projects as assigned

Clinical QA Supervisor

• The Clinical QA Supervisor is responsible for the oversight of the review of Physician reports and accompanying medical records to ensure that the report is complete, accurate, and consistent with medical evidence.
• Oversight of QA staff
• - Ensure appropriate QA staff are assigned to each file to designate file handling responsibilities amongst the team.
• - Supervise the assigned staff and manage the File Review Board to ensure a timely and accurate process of each file.
• - Provide details of board reviews to managers to ensure efficiency and productivity of staff.
• - Assist in identifying & correcting staff performance including promotions, discipline, coaching and termination of staff.
• - Assist in hiring qualified candidates for QA open positions.
• Ensure that all QA staff adhere to and meet their specific job duties including but not limited to:
• - Following up with Physicians for outstanding reports
• - Reviewing received reports for accuracy
• - Delivering completed reports back to all applicable parties
• - Following all client-specific instructions
• - Actively participate in issue resolution by working with the required QA, physicians, account managers, and/or other related parties.
• - Ensure referrals meet the client-directed Turn Around Time (TAT).
• - Act as the liaison between the reviewer, team member and client regarding the process or status of the file.
• - Other duties & special projects, as assigned and based on business needs.

Clinical Quality Assurance Supervisor

Medical Reviewer

• Evaluate medical records and prepare concise clinical summaries
• Provide independent medical opinions in response to specific questions posed by clients
• Conduct thorough medical record reviews on orthopedic spine conditions, injuries, and treatments
• Participate in peer-to-peer discussions when necessary
• Answer client-specific questions regarding orthopedic spine diagnoses, treatment plans, and surgical interventions
• Apply current clinical guidelines and standards of care to all reviews

Orthopedic Spine Surgeon – Medical Reviewer

• The QA Specialist plays an integral role in the review process.
• Responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered.
• Responsible for the timely completion and overall completeness of a reviewer report.
• Participate in improving DS processes and work with the Manager to ensure high efficiencies.
• Provides regular report status updates to the client.
• Evaluates the Quality of physician’s report and ensures compliance with standards.
• Clarifies ambiguous report questions with clients and distributes final report.
• Works directly with physicians to ensure client questions are answered.
• Reviews each physician report for data accuracy including spelling, grammar & punctuation.
• Responsible for the final approval on cases for release to the client.

PRN Physician Advisory Services QA Specialist

• Oversight of QA staff
• Ensure appropriate QA staff are assigned to each file to designate file handling responsibilities amongst the team
• Supervise the assigned staff and manage the File Review Board to ensure a timely and accurate process of each file
• Provide details of board reviews to managers to ensure efficiency and productivity of staff
• Assist in identifying & correcting staff performance including promotions, discipline, coaching and termination of staff
• Assist in hiring qualified candidates for QA open positions
• Ensure that all QA staff adhere to and meet their specific job duties
• Following up with Physicians for outstanding reports
• Reviewing received reports for accuracy
• Delivering completed reports back to all applicable parties
• Following all client-specific instructions
• Actively participate in issue resolution by working with the required QA, physicians, account managers, and/or other related parties
• Follow up with physicians with any additional questions or need for further clarification
• Ensure referrals meet the client-directed Turn Around Time (TAT)
• Ensure correct Doctor Payment amount and Client Invoice amount upon approval of referrals
• Review reports accompanying medical records to ensure that the report is complete, that all questions posed have been addressed and that the report is free of errors
• Assist management team with intake completion
• Act as the liaison between the reviewer, team member and client regarding the process or status of the file
• Assist in communications with the requester regarding questions and issues
• Other duties & special projects, as assigned and based on business needs

QA Supervisor

Financial Planning and Analysis

• Lead the company’s forecasting engine, including monthly, quarterly, and annual forecasts
• Own the PE reporting package and partner with the CFO on board and lender reporting
• Drive data mapping and alignment across ERP, HRIS, and in-house claims management system to ensure accurate consolidated reporting
• Develop and maintain a comprehensive KPI framework for financial and operational performance
• Partner with operations leadership to deliver actionable insights and business support
• Lead scenario modeling for pricing, volume, margin, and headcount planning
• Manage the annual budget process and long-range planning
• Oversee the calculations of various sales and operations-focused bonus programs
• Support the transition from Google Sheets to a modern finance tech stack, including Power BI, Excel, and future EPM tools
• Build scalable reporting processes and documentation to support future growth and exit readiness

Director of FP&A

• Assess the quality of physician reports, ensuring they meet all client and jurisdictional standards specific to long-term disability claims
• Verify that the claims support the physicians determinations in long-term disability claims
• Read and apply policy guidelines and healthcare terminology, determining when criteria for long-term disability are met
• Provide strong customer service by working closely with clients on a case-by-case basis to deliver complete, timely, and error-free quality assurance for long-term disability cases
• Manage and provide oversight for complex long-term disability cases requiring additional review prior to returning to the client
• Serve as an additional level of QA for cases with quality issues, utilizing clinical claims knowledge specific to long-term disability
• Participate in other duties and special projects, as assigned, based on business needs

Disability Claims QA

Disability Clinical RN – Quality Assurance Specialist

Customer Support

• Intake new cases and review/verify information and requests.
• Draft cases by entering information into the Dane Street system, AccessDS.
• Work with client on any information missing pertinent to processing claim.
• Assign/schedule new cases to physicians for review based on guidelines.
• Ensure that the assigned physician has no conflict of interest.
• Monitor, process and track cases to ensure we meet deadlines.
• Update clients frequently on cases in progress.
• Ensure proper documentation for specified cases is provided to the client.

Workers Compensation Customer Service Representative

Account Executive

• Identify, target, and close large national accounts (carriers, TPAs, self-insureds)
• Lead complex sales cycles, including RFPs, pricing, and contract negotiations
• Build relationships with senior decision-makers
• Secure inclusion in SHIs and national programs
• Serve as executive sponsor for key accounts (with National Account team)
• Participate in stewardship meetings, QBRs, and performance reviews
• Deliver data-driven insights and drive cross-sell opportunities
• Ensure alignment between client expectations and service delivery
• Partner with sales leadership to roll out and grow national programs
• Work cross-functionally with operations and provider networks
• Provide market and client feedback to leadership