Personify Health

• 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 • 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 issue

• Ensure client satisfaction: Collaborate across business functions to meet client needs while following through on outstanding items until resolution. • Monitor client performance: Track internal performance to confirm client expectations are consistently met while maintaining accurate, up-to-date client records. • Resolve complex issues: Research issues, access necessary resources, and escalate to appropriate internal experts for comprehensive resolution. • Support client engagement: Participate in and host client meetings as needed while assisting in organizing open enrollment strategies, health fairs, and employee education sessions. • Assist with renewals: Support Account Managers during contract renewal process while providing ongoing analysis and strategic input for client success.

• 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.

Role Description As a Solutions and Services Architect at Personify Health, you will be an integral part of the TPA team. In partnership with the TPA leadership team, you’ll be responsible for end-to-end benefit administration solutions. This includes eligibility, claims, billing, and more, ensuring the solutions are compliant, scalable, and aligned with client and market needs. You will be the bridge between client needs, product capabilities, and operational execution, from beginning of the process to the end. - Develop end-to-end solution architecture for health plans administered through the TPA platform, always keeping the end user experience top of mind. - Map and assess current-state systems, tools, data flows, and operational processes across the TPA organization to identify fragmentation, gaps, redundancies, and opportunities to streamline. - Design future-state architecture that unifies workflows across claims, eligibility, billing, reporting, customer service, platform and product teams. - Ensure that operational teams (member services, billing, claims) have the resources and knowledge they need to support the solution after go-live. - Partner closely with Account Management, Product, Implementation, and System Configuration teams to ensure smooth delivery of promised services. Qualifications - 7 or more years of experience in healthcare, TPA operations, product, systems architecture, implementation, or related fields. - Experience mapping complex processes and building end-to-end workflow designs. - Strong ability to translate ambiguous internal needs into structured, actionable solution designs. - Proven success influencing without authority in a matrixed environment. - Excellent communication skills, including facilitation and documentation. Benefits - Competitive base salary and benefits effective day one. - Comprehensive medical and dental through our own health solutions (yes, we use what we build). - Unlimited PTO—rest and recharge time is non-negotiable. - Mental health support, retirement planning, and financial protection. - Professional development with clear career progression and learning budgets. - Mission-driven culture where diverse perspectives drive real impact on people's health. Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks. Compensation This position offers a base salary range of $100,000 - $120,000, depending on location, skills, and experience. You're eligible for our full benefits package starting day one. Our Commitment Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing. Stay Safe Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com . View all legitimate openings at personifyhealth.com/careers .

Role Description Ready to Be the Bridge Between Client Needs and Exceptional Delivery? Post-implementation is where client satisfaction is won or lost—when the excitement of launch transitions into daily operations and clients discover whether we deliver on our promises. As our Client Delivery Specialist, you'll own this critical phase, coordinating client requirements, resolving technical support issues, and ensuring cross-functional teams execute deliverables seamlessly. You'll partner with Finance, Implementation, Client Operations, Member Services, Product, and Live Services teams to translate client needs into operationally efficient solutions. Your ability to monitor issue resolution proactively, manage client communications consistently, and maintain strong internal relationships directly determines whether clients experience smooth ongoing service or frustrating operational gaps. What You'll Actually Do: - Coordinate client requirements: - Document, submit, track, communicate, and monitor client program requirements post-implementation while helping clients match needs with operationally efficient delivery options. - Build cross-functional partnerships: - Partner with internal teams across Finance, Implementation, Client Operations, Member Services, Product, DSR, and Live Services to execute client deliverables and provide agreed reporting from internal tools. - Support member services: - Resolve client-specific information needs, update training for agents, and complete documentation to enhance service delivery quality. - Monitor issue resolution: - Proactively track satisfactory resolution of client technical support issues by appropriate internal teams while maintaining working knowledge of significant tools and systems. - Manage client communications: - Coordinate with internal teams to provide timely updates on client needs and ensure consistent communication throughout the client lifecycle. Qualifications - Education & Experience: - Bachelor's degree or equivalent preferred (healthcare, health science, wellness, customer service, business management, operations, logistics) - 1-3+ years professional experience in operations/logistics, customer service, customer management, software implementation, or project management - Previous SaaS, health/wellness, or healthcare industry experience preferred - Technical Skills: - Proficiency with Microsoft Suite (Word, Excel, PowerPoint, Outlook, Teams, OneDrive) - Working knowledge of Salesforce, GenAdmin, Gainsight, MicroStrategy, JIRA, Confluence - Previous Salesforce experience preferred - Strong analytical and problem-solving capabilities with ability to identify and resolve operational issues Benefits - Competitive base salary and benefits effective day one - Comprehensive medical and dental through our own health solutions (yes, we use what we build) - Paid Time Off—rest and recharge time is non-negotiable - Mental health support, retirement planning, and financial protection - Professional development with clear career progression and learning budgets - Mission-driven culture where diverse perspectives drive real impact on people's health Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks. Compensation This position offers a base salary range of $60,000-$65,000, depending on location, skills, and experience. You're eligible for our full benefits package starting day one. Our Commitment Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing. Stay Safe Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com . View all legitimate openings at personifyhealth.com/careers .

• 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

• Develop change strategy: Create, maintain, and execute comprehensive change management strategy aligned to Project Cascadia phases, milestones, and workstreams. • Integrate with program planning: Embed change management activities into program planning, delivery, and governance to ensure alignment with delivery timelines and operational readiness. • Partner with program leadership: Collaborate with PMO/TMO, workstream owners, and cross-functional leaders to ensure change impacts are considered in decision-making processes. • Lead change impact assessments: Conduct assessments across systems, processes, roles, workflows, and customer/member experience to identify how changes affect internal teams. • Translate complex changes: Convert multi-workstream changes into clear, actionable implications for internal teams with focus on TPA Operations and non-client-facing teams. • Identify readiness gaps: Recognize readiness gaps, adoption risks, and dependencies while escalating issues through established governance forums. • Own internal communications: Manage master internal communication plan for Project Cascadia, developing targeted, role-specific communications that clearly articulate what is changing, why, when, and how teams are expected to operate differently. • Ensure communication consistency: Maintain consistent, timely, aligned communications across leadership, workstreams, and operational teams while partnering with leadership to reinforce transparent messaging. • Support operational enablement: Coordinate with operational leaders to support SOP updates, training alignment, and team readiness activities while ensuring internal teams understand operational impacts. • Drive adoption: Support sustainable adoption by clarifying expectations, reinforcing new ways of working, and proactively addressing change fatigue. • Provide governance reporting: Deliver regular reporting on change readiness, communication execution, stakeholder sentiment, and upcoming change milestones to governance forums. • Monitor and improve: Track recurring issues related to misalignment, confusion, or execution breakdowns caused by unmanaged change while highlighting success stories to reinforce engagement. • Serve as primary accountability point: Act as primary point of accountability for internal change management for Project Cascadia.

• Own full-cycle payroll operations: Manage complete bi-weekly payroll lifecycle for U.S. employees including data validation, processing, reconciliation, review, and submission with highest standards of accuracy and timeliness. • Process all compensation types: Ensure accurate processing of regular, off-cycle, termination, commission, bonus, and special compensation payments in accordance with regulatory requirements and internal controls. • Provide payroll tax governance: Oversee payroll tax compliance including registrations, filings, reconciliations, and resolution of notices across multiple jurisdictions. • Manage year-end processes: Lead quarter-end and year-end processes including W-2 review, annual filings, and all required tax documentation. • Serve as subject matter expert: Act as primary payroll escalation point and expert resource for HR, employees, Finance, Accounting, and vendors while exercising independent judgment to resolve complex payroll and tax issues. • Oversee time and attendance: Monitor time and attendance accuracy, conduct audits, and ensure compliance with state wage and hour rules while troubleshooting and resolving issues. • Anticipate and mitigate risks: Proactively identify payroll risks, analyze root causes, and implement preventive measures to maintain compliance and operational excellence. • Prepare financial reporting: Develop and analyze payroll, tax, and GL reports while partnering with Finance and Accounting to reconcile liabilities and address variances. • Maintain audit controls: Monitor internal audit controls related to payroll and lead audit readiness and responses in partnership with Accounting and external auditors. • Drive process improvement: Evaluate, design, and implement process improvements and best practices to enhance efficiency, accuracy, and compliance across payroll operations. • Communicate with leadership: Convey complex payroll concepts and risk considerations clearly to leadership and stakeholders at all organizational levels.

• 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

Role Description The role is responsible for managing complex healthcare claim negotiations and ensuring compliance with federal regulations. - Complete No Surprise Act Negotiations and defend employer groups in the NSA and IDR appeal process. - Review Itemized Bills and prepare them for physician review including OCR and Spreadsheet entry and formatting. - Prepares and negotiate settlements with providers. - Follows up with providers on unsigned settlements. - Releases claims in the various TPA systems. - Assist with SCA negotiations. Qualifications - At least 5 years of experience in a TPA, Payment Integrity, Revenue Cycle management, and/or coding. - High school diploma. - Knowledge of medical terminology and medical billing terminology. - Experience with Excel, OCR, and strong software and technical proficiency. - Attention to detail and organizational efficiency. - Ability to manage multiple stakeholders and deadlines. - Strong negotiation and dispute resolution skills. - Self-starter and self-motivated. Requirements - Must be able to remain in a stationary position 50% of the time. - The person in this job needs to occasionally move about inside the office to access office machinery, filing cabinets and meeting facilities. - Constantly operates a computer and other office productivity machinery, such as copy machine, computer printer, calculator, etc. - Frequently positions self to maintain files in file cabinets. - Frequently moves boxes or equipment weighing up to 25 pounds. - Must communicate information and ideas so others understand. Must be able to exchange accurate information in these situations. - Must be able to observe details at close range. Benefits - Competitive base salary and benefits effective day one. - Comprehensive medical and dental through our own health solutions (yes, we use what we build). - Paid Time Off—rest and recharge time is non-negotiable. - Mental health support, retirement planning, and financial protection. - Professional development with clear career progression and learning budgets. - Mission-driven culture where diverse perspectives drive real impact on people's health.