Karna, LLC

• Oversee and manage projects within Contracts Operations • Enforce quality and customer service standards for external as well as internal customers; analyze and resolving quality and customer service problems; identify trends; and recommend improvements • Accomplish productivity targets by communicating job expectations; planning, monitoring, and appraising job results; coaching and counseling • Act as the POC (Point of Contact) to clients, at times, to provide support and liaison to clients for project-specific questions/answers, and to manage project deliverables and timelines • Review and analyze daily productivity reports and ensure the team is adhering to established KPI’s

• Drive strategic, data-informed decision-making through advanced analysis, reporting, and cross-functional consulting. • Lead analytical support for network development initiatives. • Partner closely with stakeholders across multiple departments. • Translate complex datasets into clear insights, progress metrics, and actionable recommendations. • Ensure client deliverables are met by delivering accurate, timely analysis, and reporting. • Become an expert in available data sources and advise on best databases for requests. • Extract, cleanse, and validate data using tools such as Excel, SQL, and Tableau. • Execute and document repeatable workflows that define how client needs will be met across the project lifecycle. • Synthesize and enrich incoming data flows into clear narratives. • Design, track, and maintain progress metrics and dashboards that translate into clear visualizations. • Serve as an advisor and thought partner to internal stakeholders. • Build and maintain strong relationships with leaders and data users. • Develop and refine methodologies to extract, transform, and present data.

• Assist with creating contracts • Assist with large recruitment email campaigns • Assist Project Operations Manager with creating Network Development build project-specific protocols and processes • Lead and coach team members on the projects assigned to them • Monitor productivity metrics defined by Project Operations Manager and/or Project Operations Supervisor to meet client deliverables • Train team on project specific protocols and tasks • Reconcile large groups, facilities, hospital contracts and rosters to database • Provide Q&A oversight and identify and correct errors by daily review of database reports • Prepare and send final contract shipments to client • Oversee any project specific inboxes and process everything received

• Lead execution of network development initiatives across assigned clients, markets, and products; ensure on-time, on-budget delivery that meets adequacy, access, and regulatory requirements • Partner with executive leadership to translate enterprise network strategy into actionable plans, milestones, success metrics, and delivery roadmaps • Lead network design and build activities (e.g., provider targeting, adequacy analysis, prioritization, sequencing) and develop fastest-path-to-adequacy plans aligned to client and regulatory standards • Lead provider recruitment and contracting across physicians, hospitals, and ancillary providers; oversee complex negotiations including reimbursement structures, value-based arrangements, and performance terms • Balance contracting strategies across access, quality, cost efficiency, and long-term sustainability; partner with legal, finance, and analytics to support compliant, competitive contract execution • Provide senior-level client leadership: serve as a strategic contact, manage escalations, support governance, and drive satisfaction and retention • Own financial performance for assigned scope, including budget management, margin targets, forecasting, and productivity outcomes • Lead network development operations (intake, workflows, contract lifecycle management, data coordination) and continuously improve scalable operating models • Oversee analytics and reporting (dashboards, insights, performance tracking); ensure data quality and governance standards are met • Drive automation and process improvement to reduce cycle times and cost per contract • Identify risks, constraints, and opportunities; escalate proactively and drive resolution • Support growth efforts (pre-sales, solution design, proposals) and identify expansion opportunities in partnership with sales and leadership • Build and maintain senior-level relationships with provider organizations and key stakeholders

• Ensure that all claims received are processed accurately and promptly in accordance with program guidelines • Perform quality audits on claims adjudicated by claims processors and/or team leads • Reviewing and addressing provider and customer inquiries externally and internally regarding claim adjudication • Handling escalated, high dollar or complex claims for audit • Developing and maintaining claims operations policies and procedures in the claims operations manual • Resolving pended healthcare claims, prior approval requests and responding to providers • Analyzing claims to determine whether or not the claims should be approved or denied for payment • Applying knowledge of medical coding and various medical claims forms to the claims process • Managing daily workflow for a team of processors, including training of new processors and ongoing updated operational processes • Generating reports and analyzing the data using Microsoft Excel • Auditing the work of claims processors • Subject Matter Expert (SME) for claims processing and adjusting within and outside of the claims team

• Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. • Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios. • Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers. • Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions. • Uphold the confidentiality of patient records and company information as per HIPAA regulations. • Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability. • Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting. • Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes. • Mentors and trains new claims processors as needed.