Personify Health

Project Manager

• Own partner integrations end-to-end: Serve as the primary technical contact for partners during integration projects, custom client builds, and ongoing support — from first call to final delivery.
• Get hands-on with APIs: Run calls, test integrations, troubleshoot issues, and help partners navigate our SSO, APIs, and platform standards using tools like Postman.
• Translate requirements into action: Gather needs directly from developers and convert them into clear user stories and use cases that Product and Engineering can execute on.
• Keep the Developer Portal sharp: Own the content and administrative aspects of the portal — ensuring documentation, API guides, and integration standards are accurate, current, and useful.
• Drive cross-functional delivery: Build and maintain project plans, manage timelines, resolve blockers, and keep Product, Engineering, GTM, and Operations aligned and moving.
• Communicate platform changes proactively: Stay current on API capabilities and get ahead of deprecations, upgrades, and new features — communicating impact clearly to partners and internal stakeholders.

Senior Project Manager

Manager

• Provide telephonic case management between providers, patients and caregivers to help ensure cost-effective, high-quality healthcare for health insurance plan participants
• Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs
• Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs
• Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals
• Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner; report measurable outcomes that record effectiveness of interventions
• Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care
• Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance
• Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis
• Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports
• Establish and maintain working relationships with healthcare providers, client/group, and patients to provide emotional support, guidance and information
• Evaluate and make referrals for wellness programs
• Maintain complete and detailed documentation of case managed patients in Eldorado and UM Web; maintain site specific files ensuring confidentiality; prepare reports and updates at 30-day intervals for high-risk cases and 90 days interval for low-risk cases ensuring confidentiality according to Company policy and HIPAA
• Perform Utilization Review for assigned members.
• Serve as mentors to LVNs and provide guidance on complicated cases as it relates to clinical issues

Case Manager Nurse – RN, Part-Time

Account Manager

• Serve as primary client contact: Act as the main point of contact for assigned clients, responding promptly to inquiries and providing creative solutions that meet client needs.
• Monitor service delivery: Track and manage service levels to ensure timely issue resolution, compliance, and adherence to contractual commitments.
• Prepare client reporting: Develop and deliver standard and custom client reports covering claims, utilization, and other key metrics for client review.
• Coordinate internal resources: Partner with cross-functional teams across claims, eligibility, and compliance to meet client needs and deliver seamless service.
• Support strategic initiatives: Assist with renewals, plan changes, and strategic initiatives while supporting delivery of QBRs and renewal processes.
• Maintain documentation: Keep accurate client records, communication logs, and CRM system entries to ensure continuity and accountability.
• Escalate appropriately: Identify and escalate complex issues to Strategic Account Executive or Director when client needs exceed standard resolution pathways.
• Support client onboarding: Assist with new client onboarding and internal system setup to ensure smooth transitions.
• Stay regulatory-informed: Maintain knowledge of regulatory issues affecting benefit plans and proactively update clients when requirements change.
• Develop product expertise: Build thorough knowledge of Personify Health benefit-related products through ongoing training and product updates.

Account Manager, TPA

• Provide telephonic case management between providers, patients and caregivers to help ensure cost-effective, high-quality healthcare for health insurance plan participants
• Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs
• Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs
• Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals
• Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner; report measurable outcomes that record effectiveness of interventions
• Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care
• Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance
• Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis
• Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports
• Establish and maintain working relationships with healthcare providers, client/group, and patients to provide emotional support, guidance and information
• Evaluate and make referrals for wellness programs
• Maintain complete and detailed documentation of case managed patients in Eldorado and UM Web; maintain site specific files ensuring confidentiality; prepare reports and updates at 30-day intervals for high-risk cases and 90 days interval for low-risk cases ensuring confidentiality according to Company policy and HIPAA
• Perform Utilization Review for assigned members
• Serve as mentors to LVNs and provide guidance on complicated cases as it relates to clinical issues

Case Manager – Nurse, RN

Director

• Ready to lead health plan configuration and solution design, driving the full lifecycle of plan build and cross-functional execution across a complex TPA environment?
• Lead and develop the teams overseeing Plan Configuration and Solution Architecture functions
• Provide strategic oversight of plan build operations ensuring accuracy, efficiency, and on-time delivery
• Drive continuous improvement across both functions, identifying process gaps and building solutions
• Partner closely with Plan Configuration to ensure solution designs are buildable, scalable, and delivered on time
• Support pre- and post-sale solutioning efforts, translating complex client requirements into viable plan designs
• Own and manage the operational project portfolio for the TPA side of the business

Senior Director, Plan Configuration & Documentation

• Drive client success: Deliver exceptional client satisfaction while supporting annual contract renewals and identifying opportunities for revenue growth across your book of business.
• Manage contractual obligations: Ensure all contractual commitments are fulfilled and proactively escalate risks to appropriate Personify Health leadership before they impact relationships.
• Own strategic relationships: Act as primary relationship owner throughout client lifecycle, providing strategic guidance and partnership that builds trust and credibility.
• Communicate product vision: Articulate product roadmap and engagement strategies with enthusiasm across channels including in-person meetings, calls, and webinars.
• Enable growth opportunities: Expand client engagement beyond traditional wellness by identifying and promoting broader platform capabilities aligned with client objectives.
• Deliver insight-driven strategy: Present analytical reviews of client performance and translate findings into actionable recommendations that support client goals.
• Advocate internally for clients: Represent client voice internally, collaborating cross-functionally to enhance service delivery and product offerings.
• Provide implementation oversight: Deliver strategic oversight during onboarding and implementation phases for assigned accounts to ensure clean launches and stable adoption.
• Collaborate on operations: Partner with Delivery Specialists (designated or pool depending on service model) and operational teams to manage day-to-day account activities.
• Design engagement strategies: Create and execute engagement plans that drive program participation and measurable outcomes for client populations.
• Maintain system accuracy: Keep accurate and up-to-date records in internal systems (Salesforce, Gainsight) to support forecasting, planning, and team continuity.
• Build product expertise: Maintain comprehensive understanding of all Personify Health solutions and services to position capabilities effectively.
• Resolve client inquiries: Ensure timely and effective resolution of routine client questions and concerns while maintaining positive relationships.
• Support special projects: Contribute to cross-functional initiatives and special projects as assigned to strengthen overall operations.

Account Manager, Wellbeing

• Lead and develop your team: Mentor, coach, and manage a team of Implementation Project Managers at varying experience levels, providing day-to-day guidance that builds capability and drives consistent, high-quality delivery across the portfolio.
• Own complex client implementations: Serve as the client-facing expert on all operational aspects of Personify Health's health plan administration solutions — managing timelines, dependencies, risks, and stakeholder alignment from kickoff through go-live.
• Drive proactive risk management: Identify implementation risks, dependencies, and barriers early, escalating issues and coordinating cross-functional resolution before they become client problems.
• Manage escalations and ensure seamless handoffs: Resolve client and broker concerns with urgency and professionalism, and partner with account management and operations teams to ensure clients transition out of implementation without missing a beat.
• Support business growth: Participate in pre-sales activities including RFP responses, prospect meetings, finalist presentations, and operational solutioning — bringing implementation credibility to the sales process.

Manager, Implementation Project Management – TPA

Operations

• Own a portfolio of cross-functional projects: Draft project charters, build and maintain detailed project plans, manage milestones and dependencies, and drive teams through to completion — across one-time initiatives and annually recurring programs alike.
• Redesign how work gets done: Analyze existing processes for bottlenecks and inefficiencies, then design and implement solutions that reduce cycle times and sharpen operational performance across the organization.
• Keep documentation and governance sharp: Develop and maintain SOPs, process flowcharts, and diagrams — partnering with functional SMEs to ensure documentation stays accurate, current, and usable in practice.
• Lead change with intention: Build change management strategies, communication plans, and training rollouts that help cross-functional teams adopt new processes and frameworks without losing momentum.
• Coordinate incident response: Manage communications across internal and external stakeholders during incidents and outages, maintaining escalation protocols and ensuring the right people have the right information at the right time.

Senior Process Manager

Account Executive

• Broker distribution and development
• Interpreting and qualifying Requests for Proposals (RFP’s)
• Experienced user of Salesforce.com
• Ability to cold call prospects and brokers
• Ability to present wellness solutions with a virtual format and the use of power point
• Help to manage, implement, deliver, evaluate and improve all workplace wellness programs and resources
• Ability to be consultative in all things well-being
• Become expert in all ancillary wellness services that are offered and have the ability to provide strategic direction for prospects and current clients
• Able to generate new leads via broker and direct to end user sales channels
• Build and sustain positive relationships with the entire Wellness IQ staff
• Ability to present and sell to consultants or employer groups of 50-1500 employees
• Interact with staff, management and vendors to ensure operational efficiency and effectiveness
• Frequent travel required

Sales Executive

Business Analyst

• Gather and document requirements: Analyze and document business and technical requirements for client migrations, ensuring accuracy, consistency, and reliability across all documentation.
• Define system configurations: Support configuration of claims systems including benefits, eligibility, accumulators, and workflows to match client operational needs.
• Document data operations: Define and validate data operations endpoints, file feeds, and integrations to ensure accurate data flow between systems.
• Configure portal functionality: Support configuration and validation of benefit plans, member portal, and client/broker admin portal functionality.
• Partner on testing: Collaborate with Data Operations team to support testing, defect resolution, and validation activities throughout implementation lifecycle.
• Identify gaps and solutions: Recognize data, configuration, and process gaps and recommend solutions to ensure successful client transitions.
• Maintain tracking systems: Document all efforts in internal tools and ticketing systems to ensure information is current and accessible to project teams.
• Support change management: Handle change management activities related to scope changes or enhancements during implementation while maintaining project momentum.
• Participate in client meetings: Engage in client-facing meetings as needed and requested to clarify requirements or validate configurations.

Business Analyst, TPA Client Migrations

• Supervise day-to-day operations of assigned Utilization Management staff, including scheduling, workload distribution, and adherence to established workflows.
• Provide full people management for assigned Utilization Management teams, including hiring, performance management, and staff development.
• Provide routine coaching, feedback, auditing, support and disciplinary action to ensure productivity, quality, and timeliness standards are met.
• Monitor documentation for completeness, accuracy, timeliness and compliance with company policies and regulatory requirements.
• Analyze operational and quality data to identify trends, gaps, and opportunities for improvement.
• Drive team performance against key metrics, including engagement, productivity, quality scores, and turnaround times.
• Collaborate with cross-functional partners to resolve issues and improve care coordination.
• Prepare team for internal and external audits (e.g., NCQA, URAC) and support responses to findings.

Utilization Review Manager

• Lead account operations: Oversee all aspects of Northwell account including Member Services, Claims Operations, Account Management teams, and all 100% dedicated personnel to ensure operational excellence.
• Build executive relationships: Establish rapport and credibility with account stakeholders at all organizational levels through consistent executive presence, depth of domain knowledge, and diligent preparation.
• Drive clinical cost strategy: Partner with medical management team to review clinical cost experiences, strategize cost containment approaches, and realize significant savings from these strategies.
• Own strategic outcomes: Maintain accountability for reliable revenue, expansion, and clinical outcome targets that translate deep relationships into material value.
• Identify client objectives: Proactively understand client objectives, challenges, and leadership priorities while uncovering barriers and developing actionable, client-specific strategic plans that maximize satisfaction, success, and ROI.
• Deliver business insights: Develop and present business reviews deriving insights from data, helping clients plan future direction with insights into health costs and procedural cost experience, plus executive reporting, strategic planning, product capability overviews, and thought leadership presentations.
• Ensure client satisfaction: Support positive client satisfaction scores and provide oversight for proactive action plans required to maintain positive relationships and secure referenceable client status.
• Monitor contractual obligations: Confirm all client contractual obligations are met and communicate contractual risks to appropriate Personify Health leadership.
• Lead by example: Set high standards, provide meaningful coaching, support cross-functional teams, and model diligent preparation, consistent delivery, and continuous improvement across all accountable actions.
• Contribute to leadership team: Serve as member of Client Growth Leadership Team to develop and instill consistent standards of excellence while guiding and sustaining diverse, high-performing teams.
• Represent Personify Health externally: Participate in thought leadership presentations, industry conferences, and client events as needed to elevate brand presence.
• Support broader organization: Collaborate with other Personify Health departments as needed to drive enterprise success.

Senior Director, TPA Key Accounts

• Provide telephonic case management between providers, patients and caregivers to help ensure cost-effective, high-quality healthcare for health insurance plan participants
• Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs
• Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs
• Develop treatment plan for standard and catastrophic cases
• Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner
• Report measurable outcomes that record effectiveness of interventions
• Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care
• Advocate for the patient by facilitating the delivery of quality patient care
• Negotiate and implement cost management strategies to affect quality outcomes
• Maintain complete and detailed documentation of case managed patients

Case Manager – Nurse RN

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Case Manager, RN

Sales Development Rep

• Qualify all incoming inquiries generated through web and marketing campaign leads
• Source new leads through cold calling and online research
• Successfully cold call and set up meetings for the enterprise sales team (via phone and email)
• Strategic sales capabilities that include a high comfort level communicating with all levels of prospects within an organization, balanced with tactical skills for a fast-paced, high volume lead follow-up and qualification environment
• Prospect into target accounts to find new revenue opportunities
• Provide feedback to Marketing regarding campaign development and execution
• Develop and articulate high-impact messaging that resonates with prospects, captures a value prop, and embodies Personify Health's values
• Consistently logging lead, contact, account, and qualification data in Salesforce.com
• Report weekly metrics
• Work with Account Executives to gain insight into individual territory and key account plans and establish lead generation priorities and methods.
• Achieve quarterly objectives