Comagine Health

• Provide daily oversight and monitoring of non-clinical staff, as assigned; also provide the supervisor with input regarding employees’ performance of all treatment types. • Provide clinical and/or review process subject matter expertise; respond to customer and provider questions or concerns. • Assist with initial orientation and training of new staff. • Create staff training schedules daily as indicated by the supervisor. • Ensure timely completion of daily training and report pertinent observations of individual and team productivity and performance to the supervisor. • Apply and assist in the development of non-clinical staff’s work process. • Retain and organize files and records, track, and monitor due dates on action items. • Provide follow-up and monitoring of non-clinical staff during their performance, as appropriate; also provide the supervisor with input regarding employees’ performance of these activities. • Screen client or customer complaints and assist with follow-up and resolution. • Respond to inbound telephone requests. • Assist in organizing and scheduling Open Forum huddles. • Participate in Provider Portal training. • Identify training needs or opportunities for improvement in process or documentation and work with Supervisor and manager to update procedures and process as needed. • Identify and report HIPAA and PHI violations in the appropriate database. • Perform other duties as assigned.

• Provide operational leadership for a team of clinical professionals performing utilization management and specialty reviews. • Ensure clinical quality, regulatory compliance, operational excellence, staff development, and financial stewardship. • Partner with Medical Directors, customers, and internal leaders to deliver outstanding clinical services. • Lead and develop a team of utilization management clinicians through coaching, mentoring, and performance management. • Oversee quality management initiatives and continuous process improvement efforts. • Manage departmental productivity, budgets, staffing, and operational performance. • Partner with Medical Directors and cross-functional leaders to develop clinical policies, workflows, and review protocols. • Support customer relationships, participate in business development activities, and contribute to proposal responses. • Monitor key performance metrics and implement improvements to enhance service delivery and operational effectiveness.

• Lead the full proposal development lifecycle, including opportunity assessment, capture planning, proposal development, submission, and internal tracking. • Facilitate proposal strategy sessions and lead interdisciplinary teams in developing compelling, compliant, and customer-focused solutions. • Coordinate proposal schedules, assignments, reviews, and final production activities to ensure high-quality submissions. • Partner with operational leaders, subject matter experts, and executives to develop innovative, competitive solutions. • Manage conference planning, logistics, exhibitor activities, and outreach efforts while representing Comagine Health to prospective clients and partners. • Provide coaching, mentoring, and cross-training to development managers, operational staff, and subject matter experts. • Support continuous improvement initiatives that strengthen proposal development processes and business development operations.

• The Program Manager supports the Program Director in ensuring the overall success of one or more strategic programs. • Lead multiple programs and projects from initiation through completion, ensuring successful delivery of high-quality outcomes. • Manage project budgets, staffing, schedules, timelines, and resource allocation. • Build and maintain strong relationships with clients, partners, and internal stakeholders. • Collaborate with project leads to coordinate work plans, staff assignments, and project priorities. • Develop and monitor project plans while proactively identifying and resolving risks and challenges. • Partner with Contracting & Compliance to develop policies, agreements, and governance processes. • Support business development activities by contributing to proposals, budgets, customer presentations, and solution development. • Ensure all program activities comply with contractual, regulatory, and organizational requirements.

• Lead complex healthcare consulting engagements from planning through successful implementation. • Serve as the primary advisor and project lead for clients, ensuring exceptional customer experience and project outcomes. • Prepare executive-level reports, presentations, recommendations, and strategic deliverables. • Facilitate workshops, executive strategy sessions, and organizational planning meetings. • Present findings and recommendations to executive leadership and key stakeholders. • Provide subject matter expertise in healthcare operations, technology, quality improvement, and organizational transformation. • Mentor and coach consultants while fostering professional growth across project teams. • Provide project-level financial oversight, including project budgets, forecasting, and resource management. • Identify opportunities to improve consulting methodologies, project delivery, and operational efficiency. • Support business development activities through proposal strategy, client presentations, conference participation, and thought leadership.

• Provide essential administrative and project coordination support to assigned departments, programs, and projects. • Coordinate project tasks, timelines, and deliverables. • Complete assigned project work while meeting deadlines. • Capture meeting notes, action items, and deliverables. • Communicate regularly with external partners. • Support work plans, scheduling, agendas, meeting minutes, and deliverable tracking. • Maintain file-sharing platforms and perform data entry and data management.

• Assess the medical necessity and quality of healthcare services through utilization management reviews • Conduct prospective, concurrent, and retrospective utilization management reviews • Apply clinical review criteria, organizational policies, guidelines, and screening tools (InterQual) • Consult with physician/practitioner consultants when services do not meet medical necessity criteria • Collaborate with internal teams and refer cases for additional review or escalation as appropriate • Refer cases to management when required • Provide clinical and utilization review subject matter expertise • Respond to provider, customer, and stakeholder questions regarding determinations and processes • Conduct outreach to providers, case managers, consultants, and community support coordinators to obtain additional clinical information • Maintain accurate documentation and comply with all regulatory and contract standards

• Lead enterprise data engineering and AI enablement initiatives aligned with business strategy. • Design and evolve modern cloud-based data platforms, including data lakehouse, warehouse, and streaming architectures. • Identify, prioritize, and implement high-impact AI and machine learning use cases across the organization. • Establish responsible AI practices, governance, security, and ethical standards. • Provide strategic guidance on AI opportunities and implementation approaches. • Oversee data architecture, integration, governance, quality, and scalability. • Build, mentor, and lead a high-performing team of data engineers and AI professionals. • Manage technology vendors, cloud platforms, and AI tools supporting enterprise capabilities.

• Administering face-to-face assessments and person-centered service planning (in partnership with individuals and their designated agents) • Continuous monitoring of service plans, • Assisting with transitions from and between community and institutional settings.

• Support ESRD operational workflows, CMS forms processing activities, and operational tracking processes • Validate, update, and maintain information within End Stage Renal Disease Quality Reporting System (EQRS) and other internal systems to support data quality and reporting activities • Maintain operational records, documentation, tracking systems, and internal databases • Manage communications and follow-up activities with dialysis facilities, CMS contacts, vendors, help desk teams, and external partners • Monitor and route communications through shared phone, email, and virtual fax systems • Support facility onboarding, closure activities, and related operational processes • Prepare reports, reminders, meeting materials, operational correspondence, and recurring resources • Coordinate scheduling, Outlook invitations, Zoom meetings, shipment tracking, operational mailings, and meeting logistics • Assist with workflow documentation, process standardization, and operational support initiatives • Support department operational priorities, annual meetings, and other team activities as assigned