Liviniti

Operations

• Own the eligibility product roadmap, annual planning, and enhancement prioritization.
• Translate client and operational requirements into development-ready specifications.
• Own benefit-level configuration oversight and vendor integration strategy.
• Identify automation and AI-assisted workflow opportunities within the eligibility function.
• Own the eligibility function's contribution to platform migration initiatives, including testing sign-off, migration validation, and post-go-live stability.
• Keep the team's work visible to leadership through dashboards, reporting, or equivalent tools.
• Provide strategic oversight to the EDI/Eligibility Manager and maintain ultimate accountability for team performance and quality.
• Represent the eligibility function in client conversations and cross-functional leadership discussions.

Director of Eligibility Operations

Content Writer

• The Proposal Strategist/Writer manages high complexity weighted proposals.
• The Proposal Strategist/Writer works closely with leadership throughout Liviniti to create customized responses to RFx documents that differentiates Liviniti in the market, while developing strategic content tailored to the needs of clients.
• This role performs the full range of tasks required to develop a strategic and compliant proposal that is in alignment with client requirements and Liviniti’s brand guidelines.
• Provides leadership and guidance of the proposal response, including several SME functional areas and senior leaderships to help in articulating solutions that are in alignment with proposal requirements and client needs.
• Creates new proposal text by meeting with subject matter experts or using reference documents.
• Edits proposal language to ensure compliance with proposal requirements and incorporates strategic win themes or solutions into the proposal.
• Performs a thorough compliance review and quality check of drafts and final proposal version.
• Develops a proposal calendar and proposal project plan to ensure the proposal remains on track.
• Provides proposal health updates to leadership throughout the proposal development stage, ensuring that milestones are met.
• Schedules, coordinators, and participates in color team reviews ensuring compliance with solicitation requirements and client need.
• Uses proposal management tools for the effective outreach and engagement of key stakeholders throughout the organization.
• Analyzes compliance-driven/technical documentation to determine customer requirements and to understand complex customer issues within the PBM industry.
• Formats responses into a professional template in alignment with Liviniti's brand standards.
• Participates in proposal kick-off meetings and facilitates discussion on areas of concern.
• Reviews and edits content and coordinates with senior leaders to ensure accuracy of revisions.
• Submits proposals by the identified due date, coordinating the submission; proactively identifies, communicates, and develops risk mitigation plan to support revenue-generating proposals for Southern Scripts.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).

Proposal Strategist – Proposal Writer

Care Navigator

• Conduct case management on behalf of the client and Southern Scripts.
• Provide targeted, personalized service based on a holistic view of the member.
• Engage members through telephone, correspondence, fax, or app.
• Assist members in understanding components of Southern Scripts products.
• Support the success of Southern Scripts and our clients through the development of member-centric solutions.
• Maintain compliance with ERISA, HIPAA, and client specific requirements.
• Work as part of a team to meet business unit objectives.

Associate Care Navigator

Account Executive

• Support pharmacy benefit management programs with the development of clinical strategies
• Develop new clinical strategies and provide oversight of clinical programs
• Analyze, interpret, and develop recommendations using prescription claims data
• Participate in client implementation meetings and maintain client relationships
• Make recommendations for clients regarding drug pipeline activity
• Provide drug information and operational expertise
• Analyze and evaluate pharmacy data and reporting
• Develop communication materials regarding formulary and utilization management changes
• Support customer service department when clinical claim review is needed
• Collaborate with cross-functional teams and report on various responsibilities

Clinical Account Executive

• Monitor and manage daily RxCompass operational queues to ensure timely processing and service level adherence.
• Ensure coordinators actively work assigned queues and meet turnaround expectations.
• Review queue aging, backlog, and case status to maintain operational flow and prevent service delays.
• Rebalance workloads as needed to ensure equitable distribution of work across team members.
• Monitor team KPIs, including productivity, queue throughput, quality scores, adherence, and service levels.
• Conduct regular performance check-ins with team members to reinforce expectations and performance standards.
• Identify performance gaps and provide real-time coaching to improve operational outcomes.
• Escalate performance concerns to the Manager when corrective action may be required.
• Ensure team members follow established workflows and SOPs for RxCompass program processes.
• Track and address aging cases or unresolved items that may impact member service delivery.

Supervisor, RxCompass Operations

Paralegal

• As a Paralegal &ndash; Contracts & Compliance, responsible for supporting Liviniti&rsquo;s Legal and Compliance Department through contract administration, regulatory and licensing support, and day-to-day legal operations.
• Prepares client and vendor contracts and other legal documents from standard forms for review, approval, and use by Legal Counsel and Legal Department.
• Assists with online legal ticketing system, including reviewing ticket inquiries, preparing necessary documentation, responding to ticket inquiries, maintaining ticket organization, and adhering to expectations regarding turnaround times.
• Assists in maintaining the internal database for ticket and contract tracking.
• Files correspondence and legal documents in the companywide contracts database or file server.
• Assists with client and vendor contract follow-up for all company contracts and other legal documents sent out by the Legal Department.
• Assists in responses to redlines on common or standard requests in a timely manner.
• Assists in Request for Proposal tasks, as needed.
• Assists with coordinating, preparing, and submitting applications for all licenses and registrations within the company to ensure timely submissions and maintain licensing files.
• Researches and analyzes law sources such as statutes, recorded judicial decisions, legal articles, and legal codes.
• Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company. Abide by all obligations under HIPAA related to Protected Health Information (PHI).
• Assists Legal Counsel, Manager, and Administrator with various tasks, as needed. Performs clerical duties such as scheduling appointments and providing information to callers.
• Participates in special legal projects, as assigned.

Paralegal – Contracts & Compliance

Proposal Manager

• The Proposal Coordinator provides sales and proposal administrative support for our Proposal Strategist as well as administrative support for the Liviniti Sales Team.
• This essential position requires a self-starter who will assist in the initial receipt, internal documentation and provision of inquiries (when necessary) to the Proposal Strategist in order to facilitate a complete response to the requestors.
• The Proposal Coordinator assists in formatting responses into a professional template for client delivery within a specified timeframe.
• This position supports new organizational sales including the coordination of requested analyses and proposal (RFP) responses for prospect delivery.
• The Proposal Coordinator will work with the Sales/Proposal team in supporting updates to the Proposal Library of approved responses.
• Maintaining and loading new prospects in our system.
• Also maintains relevant information in the platform including pertinent meetings, forecast category, revenue projections, etc.
• Coordinate proposal reviews, ensuring compliance with solicitation requirements.
• Support and maintain a proposal library/database.
• Support and maintain inventory of all opportunities – past, present, and future.
• Receiving and logging new requests into the dashboard.
• Supports the buildout of a question/answer database.
• Assistance completing the more basic proposals.
• Establishes, develops, maintains and updates electronic document management systems, and assists in the retrieval of information from files when needed.
• Organizes and prioritizes large volumes of information and calls.
• Works independently and within a team on special nonrecurring and ongoing projects.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).

Proposal Coordinator

Customer Success Manager

• Ensure the success and satisfaction of health system and hospital clients.
• Manage client relationships and oversee the implementation process.
• Drive project management initiatives to enhance client experience and operational efficiency.
• Respond to all client inquiries and address needs in a timely manner.
• Prepare account management-related documents and follow-ups from client meetings.
• Ensure discussions are documented and follow-ups are delivered within timelines.
• Maintain records of project information and objectives of assigned clients.
• Adhere to procedural and quality standards.
• Utilize project management skills to track milestones and deliverables.
• Oversee and manage all ID Card processes and issues.

Client Success Coordinator

Account Manager

• An Account Manager owns the day-to-day customer service and support for their assigned clients to deliver best-in-class service and ensure all client needs and objectives are met.
• This role is responsible for ensuring project deliverables and timelines align with client service agreements and requirements, service levels are achieved, identified issues are resolved timely, and client satisfaction is achieved.
• This role works in tandem with the Account Executive to ensure the client’s strategic plan is executed.
• Functions include, but are not limited to: Providing timely responses to all client inquiries and addressing all client needs.
• Can prioritize competing priorities effectively and/or request support when needed.
• Works effectively across organizations to resolve client needs with a sense of urgency.
• Learns from Account Executive to better understand client utilization and needs.
• Ensures full understanding of client benefit package intent.
• Effectively and proactively communicates with clients and ensures that all communications are easy to understand.
• Delivers quality products in every interaction.
• Continues to focus and invest time in learning the Liviniti product suite and process interworking.
• Preparing account management-related documents such as member documents, meeting reports, and other client communications and correspondence.
• Ensuring all discussions are documented, and follow-ups are captured and delivered to committed timelines.
• Maintaining current work-in-progress records and archives of past project information as appropriate.
• Validating all systems accurately reflects their intent.
• Provide proactive communication with clients.
• Abide by all obligations under HIPAA related to Protected Health Information (PHI). Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.

• Claims Processing & Quality Review Process, load, and quality review incoming vendor claims submissions across multiple vendors, ensuring accuracy and adherence to strict processing timelines
• Claims Reconciliation & Issue Resolution Reconcile vendor claim files against internal processing records, payment files, remittance reports, and outstanding vendor balances
• Claims Aging, Reporting & Escalation Track claims received, claims processed, claims rejected, claims pending, and claims resolved
• Vendor & Cross-Functional Collaboration Maintain consistent communication with vendors and stakeholders throughout the claims lifecycle
• Process Improvement & Documentation Support the development and maintenance of standard operating procedures, trackers, and reporting tools related to vendor claims processing and reconciliation
• Compliance & Confidentiality Maintain confidentiality of sensitive medical information and comply with HIPAA Privacy and Security Rules