Bluespine-Savings Realization Manager

Bluespine is an innovative health-IT startup on a mission to transform healthcare spending for self-insured employers. 

Using cutting-edge technologies, we build AI-driven systems that uncover what's going wrong in healthcare spending, from billing errors to wasteful care, and identify concrete opportunities for employers to save. Every assessment is tailored to the individual claim, taking into account the relevant provider, payer, and plan, so our results are precise and trustworthy. 

Location: US-based, remote. 

About the Role 

Actionable insights only create value when they're put into action. As our first Savings Realization Manager, you'll bridge the gap between insight and impact: you'll work with employers and their vendors to turn Bluespine's insights into realized savings, and bring what you learn back to our product team. 

You will: 

• Own the path from recommendation to realized savings for your assigned customers: prioritize opportunities, build the action plan, drive execution, and track outcomes. 
• Work directly with medical carriers and TPAs, including case management teams, account managers, and escalation contacts, to facilitate handoffs with the appropriate information and monitor progress. 
• Act as a benefits consultant for the customer: advise on plan design changes, member steerage and communication, point-solution decisions (add, optimize, or retire), and direct contracting opportunities. 
• Work with employer HR, benefits, and finance stakeholders to get buy-in, sequence changes around plan-year timelines, and handle internal obstacles. 
• Report on realized versus recommended savings, and on what is blocking progress. 
• Bring field knowledge back to the product. Work with Product and R&D to turn what you learn (which recommendations stall, why, and what carriers and employers actually do) into improvements to our recommendation engine and workflows. 
• Help define how this function works at Bluespine: playbooks, tooling, and the operating model that could later become a team. 

• 6+ years of experience in US employer-sponsored health benefits, in at least one of: a benefits broker or consultancy, a carrier or TPA (account management or case management), a care navigation or point-solution company, or patient advocacy. 
• Hands-on knowledge of self-funded plan mechanics: plan design, stop-loss, carrier and TPA operations, PBM and pharmacy benefits basics, and how claims and case management work. 
• A track record of driving change through external parties, such as carriers and vendors, where you had influence but no authority. 
• Comfort working with data: you can read data-driven analyses, understand the logic behind a recommendation, and explain it to a non-technical HR leader. 
• Excellent written and verbal communication skills, with both senior employer stakeholders and operational carrier contacts. 
• Startup experience, or the mindset to build a role and process from scratch with little structure and a lot of ownership. 

Advantages 

• Experience with direct contracting, reference-based pricing, or carve-out arrangements. 
• Experience with point-solution evaluation or vendor management. 
• Exposure to product work, such as giving structured feedback to a product or engineering team. 
• Experience with payment integrity, claims editing, or healthcare analytics. 

What We Offer 

• A high-impact, first-of-its-kind role where you define how Bluespine turns insight into results. 
• Real visibility to executives, and autonomy to shape the function. 
• The chance to grow from individual contributor into leading a team as the function scales. 
• Competitive compensation and meaningful equity.