Health Network One

• Responsible for developing, maintaining and supporting the day-to-day Specialty Provider Networks (SPN) contracting initiatives. • Key Responsibilities: Coordinate the prospecting calls to potential providers for inclusion in the targeted SPN. • Generate leads for SPN contracting via different methods. • Coordinate the entire contracting process for all potential providers, including prospecting, negotiation and credentialing. • Collect all providers signed contracts, applications and necessary credentialing information. • Support the activities of Network Development for the corresponding SPNs assigned. • Ensure integrity of data entered into Company systems and/or databases. • Perform additional duties and related essential duties as assigned.

• Build pricing and underwriting models and analyses to guide new deal pricing and review of existing pricing arrangements. • Perform detailed medical cost, utilization, and trend analyses to support rate development and pricing recommendations. • Evaluate profitability of quotes, renewals, and book-level performance relative to pricing assumptions. • Track performance of existing contracts. • Support evaluation of risk and pricing strategies for new and existing products through multiple scenarios, such as base, downside and upside cases. • Analyze and assess the integrity of the data being used for underwriting. • Identify and recommend mechanisms and contract terms that mitigate known and unknown risks and uncertainties. • Partner with operations, medical economics / business analytics, product, sales, account management and others as appropriate, including providing guidance during the proposal, diligence and contracting phases regarding data and analytics requirements to ensure strong underwriting can be achieved, along with maximizing outcomes and minimizing risk. • Maintain data integrity and accuracy in pricing and underwriting databases. • Perform additional duties as assigned.

• Lead development of pricing strategies for new business, renewals, and strategic client expansions • Analyze large volumes of healthcare data and build robust pricing models incorporating utilization, PMPM trends, network economics, and administrative cost assumptions • Translate clinical, network, and operational assumptions into clear, defensible financial models • Create and maintain benchmarks by line of business using historical utilization, cost, and performance trends to inform pricing assumptions and proposal strategy • Analyze historical trends to identify key cost and utilization drivers, variability, and risks across products, markets, and populations • Conduct scenario analysis, sensitivity testing, and margin evaluation to inform price‑to‑win decisions • Prepare and present pricing insights, financial rationale, and trade‑off analyses to executive stakeholders and health plan partners • Own the end‑to‑end pricing workflow for proposals, including intake, prioritization, modeling, review, and final submission • Coordinate closely with Sales, Growth, Product, Network, and Clinical teams to align technical, operational, and financial components • Create executive‑ready pricing summaries and recommendations for leadership review • Lead discussions with health plan partners by clearly explaining pricing assumptions, utilization drivers, and value propositions • Partner with Finance on performance tracking, variance analysis, and ongoing refinement of pricing assumptions • Contribute to continuous improvement of pricing tools, templates, benchmarking frameworks, and governance processes • Perform other duties as needed.

• Support the CFO and FP&A teams in developing financial models and preparing budgets. • Analyze performance and deliver insights that drive decision-making. • Collaborate with team members to prepare monthly and quarterly reporting packages. • Assist with monitoring and analyzing monthly financial results, identifying trends and budget variances. • Prepare and automate KPI dashboards and financial reports to enhance visibility.

• Serve as the primary day to day strategic lead for assigned healthcare payor accounts, supporting client strategy, satisfaction, retention, and growth. • Responsible for maintenance of comprehensive account strategy plans aligned to client business goals, market dynamics, and organizational objectives. • Proactively manage client escalations, risks, and sensitive business issues with urgency and professional communication. • Support the planning and preparation of annual business reviews, strategic planning sessions, and other client-facing meetings. • Escalate client concerns or risks to the VP, Account Management as appropriate. • Assist in executing account management strategies and initiatives defined by leadership. • Coordinate internal resources to ensure timely delivery of services and solutions to clients. • Track key deliverables, timelines, and action items across assigned accounts. • Support implementation of health plan strategies in collaboration with internal teams. • Maintain working knowledge of health plan operations, regulatory requirements, and industry best practices. • Support compliance with client requirements and industry standards. • Assist in gathering and analyzing data to support client reporting and strategy execution. • Track and report on key performance indicators (KPIs) for assigned accounts. • Prepare client reports, presentations, and performance summaries. • Identify trends, risks, and opportunities, and communicate insights to leadership. • Partner with internal stakeholders including operations, clinical, product, and finance teams to support client deliverables. • Ensure alignment across teams to meet client expectations and service standards. • Support renewal and rate update processes by gathering required data and preparing materials. • Identify opportunities for account expansion or additional services and communicate to leadership. • Assist in maintaining high client retention and satisfaction. • Support the VP, AM to oversee client contract lifecycle activities, including renewals, amendments, participate in pricing discussions, and strategic negotiations. • Partner with internal legal, finance, underwriting, operations, and executive leadership teams to support contract strategy and execution. • Work with VP, AM to ensure contract terms align with business objectives, profitability expectations, and operational capabilities.

• Lead analytics initiatives supporting total cost of care performance across specialty services • Identify drivers of specialty spend across specialties such as vision, dermatology, therapy etc., • Monitor PMPM trend performance across specialties and all lines of business. • Evaluate utilization patterns and recommend cost-reduction opportunities • Design analytics frameworks measuring provider efficiency, access, and quality performance • Evaluate book-of-business claims experience to develop insights on profitability and competitive positioning across products and markets • Support underwriting and growth teams with data analysis and insights for new client proposals and value propositions • Analyze site-of-care optimization opportunities, network leakage and utilization across provider networks • Support contract performance evaluation and savings analysis • Partner with finance, clinical and operational leadership to define and develop KPIs aligned with enterprise performance goals. • Present insights and recommendations to leadership in a clear, concise, and data-driven manner • Lead cross-functional collaboration with IT, data engineering, operations, and quality teams to improve data architecture and reporting accessibility. • Mentor junior analysts and strengthen analytics capabilities across teams. • Drive automation of manual reporting workflows and implementation of scalable reporting solutions. • Establish documentation standards, reporting governance processes, and analytics best practices. • Support integration of AI tools into technical operations • Perform other duties as needed

• Define and champion the organization’s technology vision and multi-year IT strategic plan in alignment with overall business strategy. • Develop roadmaps for key capabilities (e.g., digital platforms, EDI/data management, infrastructure upgrades) and ensure IT initiatives deliver measurable business value. • Establish and maintain IT governance processes (e.g., architecture review, change control, portfolio management) for effective decision-making and risk management. • Act as a business partner to the COO, CEO, and other C-level leaders, translating business goals into IT priorities and ensuring technology initiatives are integrated into enterprise planning. • Lead enterprise-wide technology transformation initiatives, such as modernizing legacy systems, migrating to cloud-based solutions, and implementing advanced analytics and AI to enhance operations.

• Lead Network Operations (Shared Services), a centralized function that builds and owns the frameworks, tools, operating cadence, and standards used by all network segments to execute contracting, credentialing, training, and provider support. • Design and implement a single intake-to-execution workflow to make demand visible, prioritized, and governed. • Establish and manage operating cadence, throughput tracking, and dashboards (cycle time, capacity, delivery). • Reduce duplication and manual handoffs across segments while improving speed to market. • Partner with segment leaders to ensure shared services delivery aligns to segment priorities. • Own the Network Financial Value Framework and performance dashboard (unit cost, utilization, leakage, VBC outcomes), partnering closely with Finance, Analytics, and Actuarial to integrate network economics into enterprise financial planning and board reporting. • Build a scalable operating model that supports growth without proportional headcount increases. • Act as a thought partner and extension of the EVP, helping prioritize initiatives and manage executive bandwidth. • Serve as the first escalation point for cross-segment issues, resource constraints, and operational blockers. • Provide line-of-sight across all network segments and shared services to anticipate risks and opportunities. • Ensure alignment between enterprise priorities and network execution. • Support preparation of key materials and updates for ELT/Board discussions related to network strategy and performance. • Enable effective matrixed ways of working across segment leaders and shared services. • Drive clarity around roles, decision rights, and accountability. • Lead change with a steady, pragmatic approach that builds trust and adoption. • Partner closely with Finance, Analytics, and other enterprise functions to improve economic visibility and performance reporting.

• Prepare, submit, and track initial and renewal licensing applications across multiple states and regulatory bodies, including California and Texas • Maintain up-to-date licensing records, documentation, and status tracking systems • Monitor expiration dates and proactively manage renewals to prevent lapses in licensure • Ensure all licensing files meet completeness, accuracy, and audit-readiness standards • Serve as a point of contact with licensing boards and regulatory agencies, including CA and TX licensing authorities • Respond to requests for information, deficiency notices, and follow-up inquiries • Stay informed of changes in licensing requirements and regulations, particularly within California and Texas, escalating impacts as needed • Maintain accurate data within internal systems and tracking tools • Generate reports on license status, upcoming renewals, and compliance risks • Identify discrepancies or gaps and take corrective action • Partner with Credentialing, Provider Operations, Legal, and Compliance teams to ensure alignment • Support onboarding processes requiring licensure verification or application submission • Assist with audits, internal reviews, and client reporting requirements • Provide general administrative support to the Legal/Compliance department, including triaging information requests with business stakeholders and supporting departmental initiatives, documentation, and coordination needs • Recommend process improvements to enhance efficiency, accuracy, and turnaround times • Support standardization of documentation and tracking processes • Leverage technology and systems to improve workflow management

• Lead the design, development, and optimization of enterprise clinical performance dashboards (e.g., utilization, care management effectiveness, access metrics, and quality performance). • Development of recurring and adhoc analytics using SQL, Excel, and Power BI. • Translate complex clinical datasets into strategic recommendations for executive leadership, operational teams, and quality stakeholders. • Establish data validation standards and ensure accuracy, completeness, and integrity across reporting environments. • Serve as a senior subject-matter expert for clinical analytics methodologies, performance measurement, and reporting best practices. • Partner with clinical and operational leadership to define KPIs aligned with enterprise performance goals. • Lead cross-functional collaboration with IT, data engineering, operations, and quality teams to improve data architecture and reporting accessibility. • Present insights and narratives to senior stakeholders in clear, decision-ready formats. • Guide prioritization of analytics initiatives supporting organizational strategy and regulatory requirements. • Mentor junior analysts and strengthen analytics capabilities across teams. • Partner with Compliance and clinical stakeholders to support state, federal and health plan reporting requirements, including NCQA, CMS, JOC. • Development of performance metrics used in audits, accreditation readiness, and compliance monitoring. • Support enterprise readiness for regulatory reviews through proactive analytics monitoring and documentation. • Drive automation of manual reporting workflows and implementation of scalable reporting solutions. • Establish documentation standards, reporting governance processes, and analytics best practices. • Lead initiatives to modernize clinical reporting infrastructure and improve enterprise data usability. • Identify opportunities to leverage analytics for performance optimization and cost-of-care improvement.