Medical Mutual

Title: Provider Contract Manager Location: Rossford, Ohio, 43460, United States Department: Provider Contracting Requisition Number: PROVI001237 Full-Time Hybrid Job Description: Medical Mutual employees must submit their applications through MySource. This role is hybrid role, with a strong preference for candidates located in the Northwest, OH region. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Provider Contract Manager I Job Summary: Under direct supervision, develops and maintains relationships with typically small to medium sized and/or moderately complex provider community via e-mail, telephonic and face to face outreach. Develops the provider network and national network offerings through contracting activities, relationship development, and servicing. Communicates administrative and programmatic changes and facilitates education and the resolution of provider issues. Responsibilities: - Builds relationships with assigned territory of providers, ancillary specialties, and/or national networks and with internal department staff. Explains contract provisions to internal/external customers. - Prepares non- standard contracts, amendments, and extensions. With some assistance, conducts non-standard contracts, rate, and language negotiations. - Compiles and analyzes data to support contracting negotiations and/or compliance. - Serves as a communication link between assigned providers and the Company. Provides provider service and education, including field visits. - Collaborates on issues related to billing, pricing, policy, and reimbursements. Serves as a point of contact for other internal departments (including Payer Relations, A/R, Billing, and Revenue Cycle) regarding assigned providers or National Networks and issues that may impact assigned providers. - Collaborates with other areas within Provider Engagement on Joint Operations Committee (JOC) meetings of health systems and/or National Ancillary provider groups and/or National Networks, preparing agenda and meeting minutes - Identifies program/system enhancements to reduce/minimize issues going forward. - May collaborate with other key areas on cross functional projects. - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor’s Degree in Business or Healthcare Administration, Finance, or related field. - In lieu of Degree, may consider an equivalent combination of education and experience - Experience in health insurance or a health care related field preferred. Technical Skills and Knowledge: - Intermediate Microsoft Office skills, especially Excel. - General knowledge of the health care industry and current events. - Good project management skills. - Knowledge of provider contract negotiations, regulations, etc. - Good presentation skills. Provider Contract Manager II Job Summary: Under general supervision, develops and maintains relationships with typically medium to larger sized and/or complex provider community) via email, telephonic and face-to-face outreach. Develops the provider network and national network offerings through contracting activities, contract negotiations (language and rates), drafting contracts, amendments, and extension documents, managing relationship development, and servicing. Communicates administrative and programmatic changes and facilitates education and resolution of provider issues. Responsibilities: - Builds relationships with assigned territory of providers, ancillary specialties, and/or national networks and with internal department staff. Explains contract provisions to internal/external customers. - Compiles and analyzes data to support contracting negotiations and/or compliance. - Researches and resolves complex issues that may impact future negotiations or jeopardize network retention. Reviews financial impact analyses, projections and develops negotiation work papers. Makes recommendations to assist in complex negotiations. - Collaborates with other areas within Provider Engagement on Joint Operations Committee (JOC) meetings of health systems and/or National Ancillary provider groups and/or National Networks, driving the meetings in the discussions of issues and changes - Collaborates on issues related to billing, pricing, policy, and reimbursements. Serves as a point of contact for other internal departments (including Payer Relations, A/R, Billing, and Revenue Cycle) regarding assigned providers or National Networks and issues that may impact assigned providers. - Serves as a communication link between all assigned providers or National networks and the Company. Provides provider service and education, including field visits. - Collaborates with other key area on cross functional projects. - Identifies program/system enhancements to reduce/minimize issues going forward. - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor’s Degree in Business or Healthcare Administration, Finance, or related field. - In lieu of Degree, may consider an equivalent combination of education and experience. - 2 years of experience as a Provider Contract Manager or equivalent experience in health insurance or a health care related field. Technical Skills and Knowledge: - Intermediate to advanced Microsoft Office skills, especially Excel and PowerPoint. - In depth knowledge of the health care industry and current events. - Strong project management skills. - Thorough knowledge of provider contract negotiations, regulations, contract and provider reimbursement models, and value- based concepts. - Strong presentation skills. Provider Contract Manager III Job Summary: Under minimal supervision, develops and maintains relationships with typically larger and/or more complex provider community (e.g., institutional, Physician Hospital Organization (PHO), primary care, multi-specialty, ancillary, national providers, health systems), via email, telephonic and face-to-face outreach. Develops the provider network and national network offerings through contracting activities, contract negotiations (language and rates), drafting contracts, amendments, and extension documents, managing relationship development, and servicing. Communicates administrative and programmatic changes and facilitates education and resolution of provider issues. Provides coaching and mentoring to more junior Provider Contract Managers and support staff. Responsibilities: - Builds relationships with assigned territory of providers, ancillary specialties, and/or national networks, consultants, and internal department staff. Explains contract provisions to internal/external customers. Manages contracts for off cycle relationships that are initiated during non-renewal periods. - Negotiates non-standard contracts independently. - Researches and resolves complex issues that may impact future negotiations or jeopardize network retention. Reviews financial impact analyses, projections and develops negotiation work papers. Makes recommendations to assist in complex negotiations. - Compiles and analyzes data to support contracting negotiations and/or compliance. Performs in-depth review of data and financial analysis supplied to Contracting - Serves as a subject matter expert and communication link between all assigned providers or National networks and the Company. Provides provider service and education, including field visits and seminars. - Collaborates on issues related to billing, pricing, policy, and reimbursements. Serves as a point of contact for other internal departments (including Payer Relations, A/R, Billing, and Revenue Cycle) regarding assigned providers or National Networks and issues that may impact assigned providers - Collaborates with other areas within Provider Engagement on Joint Operations Committee (JOC) meetings of health systems and/or National Ancillary provider groups and/or National Networks, preparing agenda and meeting minutes, driving the meetings in the discussions of issues and changes. Collaborates with other key area on cross functional projects. - Identifies program/system enhancements to reduce/minimize issues going forward. - Orients, trains, assists and reviews work of more junior Provider Contract Managers and support staff. - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor’s Degree in Business or Healthcare Administration, Finance, or related field. - In lieu of Degree, may consider an equivalent combination of education and experience. - 3 years of experience as a Provider Contract Manager or equivalent experience in health insurance or a health care related field. Technical Skills and Knowledge: - Intermediate to advanced Microsoft Office skills, especially Excel and PowerPoint. - Comprehensive knowledge of the health care industry and current events. - Strong project management skills. - Comprehensive knowledge of provider contract negotiations, regulations, contract and provider reimbursement models, and value- based concepts. - Strong presentation skills. - Strong financial acumen. Sr Provider Contract Manager Job Summary: Under minimal supervision for decision making, develops and maintains relationships with typically the largest and most complex provider community via email, telephonic and face-to-face outreach. Develops the provider network and national network offerings through contracting activities, contract negotiations (language and rates), drafting contracts, amendments, and extension documents, managing relationship development, and servicing. Communicates administrative and programmatic changes and facilitates education and resolution of provider issues. Provides coaching and mentoring to more junior Provider Contract Managers and support staff and assists management with special projects. Responsibilities: - Negotiates and reviews complex non-standard contracts to improve and/or keep competitive positioning that have the most strategic importance to the company. - Builds relationships with assigned territory of providers, ancillary specialties, and/or national networks, consultants, and internal department staff. Explains contract provisions to internal/external customers. Manages contracts for off cycle relationships that are initiated during non-renewal periods. - Researches and resolves complex issues that may impact future negotiations or jeopardize network retention. Reviews financial impact analyses, projections and develops negotiation work papers. Makes recommendations to assist in complex negotiations. - Compiles and interprets financial data necessary to support contracting negotiations and/or compliance and draws conclusions to make informed decisions. Takes independent action within established departmental guidelines. - Acts as Hospital/PHO, Ancillary, National Network relationship manager by assisting assigned providers with contract, claims, systems, education, and other concerns. Manages market areas by recommending and helping to implement strategies for the market. - Participates and/or takes the lead in most challenging internal or external projects. Identifies and resolves program/system enhancements to reduce/minimize issues going forward. - Serves as a subject matter expert and communication link between all assigned providers or National networks and the Company. Provides provider service and education, including field visits and seminars. - Collaborates on issues related to billing, pricing, policy, and reimbursements. Serves as a point of contact for other internal departments (including Payer Relations, A/R, Billing, and Revenue Cycle) regarding assigned providers or National Networks and issues that may impact assigned providers. - Collaborates with other areas within Provider Engagement on Joint Operations Committee (JOC) meetings of health systems and/or National Ancillary provider groups and/or National Networks, preparing agenda and meeting minutes, driving the meetings in the discussions of issues and changes - Orients, trains, assists and reviews work of more junior staff. - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor’s Degree in Business or Healthcare Administration, Finance, or related field. - In lieu of Degree, may consider an equivalent combination of education and experience. - 5 years of progressive experience as a Provider Contract Manager or equivalent experience in health insurance or a health care related field. Technical Skills and Knowledge: - Intermediate to advanced Microsoft Office skills, especially Excel and PowerPoint. - Comprehensive knowledge of the health care industry and current events. - Strong project management skills. - Comprehensive knowledge of provider contract negotiations, regulations, contract and provider reimbursement models, and value-based concepts. - Strong presentation skills. - Strong financial acumen. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. #LI-CS1 #LI-HYBRID

Title: Hospital Reimbursement Analyst Location: Cleveland, Ohio, 44144, United States Department: Provider Reimbursement Analyst Job Category: Provider Reimbursement Analyst Requisition Number: PROVI001247 Full-Time Hybrid Job Description: Medical Mutual employees must submit their applications through MySource. Note: The Hospital Reimbursement Analyst should have a strong understanding of hospital reimbursement methodologies. Alos, this is a hybrid role requiring 3 days per week on-site in our Brooklyn, Ohio office. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Performs routine to moderately complex financial analyses to support provider contracting strategies for Professional Providers. Begins to gain exposure to Institutional Provider analytics. Collaborates with Network Management and senior analysts to deliver actionable insights that support business initiatives and decision-making. Maintains market intelligence and contributes to the evaluation of network performance. Responsibilities Hospital Reimbursement Analyst - Develop complex deal models in collaboration with Network Management to support contracting. Analyze performance using utilization, cost, contract valuation, competitive benchmarks, and financial impact metrics. Communicate findings to support decision-making. - Support rate strategy development by identifying opportunities to optimize contracted rates and protect favorable structures through financial analysis. - Update and validate provider rate loading to ensure accuracy and compliance with contract terms. - Analyze emerging payment models and pricing strategies. Apply knowledge of commercial and Medicare reimbursement policies to inform contracting decisions. - Provide tactical support to senior analysts by extracting, cleaning, and preparing data for robust quantitative analysis. - Forecast contract rates and utilization trends. Build financial models and ‘what-if’ scenarios using claims and healthcare data. - Assist in building and validating rate methodologies. Ensure documentation is clear, repeatable, and aligned with update timelines. - Interpret complex contract language to assess financial implications of proposed changes. - Performs other duties as assigned. Senior Hospital Reimbursement Analyst - Collaborate with Network Management to shape rate strategies and contract methodologies that optimize financial outcomes. Identify opportunities to enhance or safeguard favorable rate structures by analyzing the financial impact of corporate initiatives, including policy changes. Deliver strategic insights through clear communication of recommendations, analytical summaries, and presentations to senior leadership. - Build and refine complex deal models in collaboration with Network Management to support contracting efforts. Apply advanced analytical techniques and business acumen to evaluate deal projections, benchmark performance, and assess financial impacts using utilization data, cost trends, contract valuation, and competitive analysis. - Ensure accuracy and consistency in provider rate loading through regular updates and quality assurance reviews. - Mentor and guide junior analysts, providing training, support, and quality oversight. Serve as a resource for resolving complex analytical and operational issues. - Partner with Actuaries and Underwriting to assess regional financial impacts of contracted rates and support short- and long-term forecasting. - Develops, builds and quality checks Institutional Reimbursement Methodologies, ensuring documentation around each build is clear and repeatable. Documents what Methodologies need to be updated when. - Forecasts contract rates, utilization trends and creates financial models using claims and other healthcare data. Creates ‘what if’ scenarios to help guide analytical decision making. - Interpret complex contract language to assess financial implications of proposed changes and support negotiation strategies. - Investigate claim disputes to validate pricing accuracy and conduct root cause analysis on inquiry data. Recommend system enhancements, targeted training, and process improvements to mitigate future errors and strengthen operational integrity. - Performs other duties as assigned. Qualifications Hospital Reimbursement Analyst Education and Experience - Bachelor’s degree in business or healthcare administration, finance, accounting, or related field. - Equivalent education and experience directly related to the role may substitute for a degree. - 3-4 years of experience as a Provider Reimbursement Analyst or equivalent progressive health care administration experience with an emphasis on Provider Contracting/Network Management. Technical Skills and Knowledge - Intermediate Microsoft Office Excel, Word, Access, and PowerPoint - Working knowledge of SAS and/or SQL; knowledge of writing queries and analytical reports preferred. - Ability to quickly learn and use software business intelligence tools. - Experience working with relational databases. Senior Hospital Reimbursement Analyst Education and Experience - Bachelor’s degree in business or healthcare administration, finance, accounting or related field. - Equivalent education and experience directly related to the role may substitute for a degree. - 5 years of experience as a Provider Reimbursement Analyst or equivalent progressive health care administration experience with an emphasis on Provider Contracting/Network Management. Technical Skills and Knowledge - Advanced financial analysis skills including forecasting and payment modeling. - Advanced computer skills including Excel, Word, Access, and PowerPoint. - Ability to utilize SAS programming language in assigned analysis. - Ability to quickly learn and use software BI tools. - Experience working with relational databases. - Ability to apply technical skills and operational knowledge to produce actionable results and analysis. #LI-JT1 Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Title: MS Dynamics 365 Technical Architect Location: Brooklyn, OH Department: IT Architecture Full-Time Hybrid Job Description: Medical Mutual employees must submit their applications through MySource. This is a hybrid‑remote role based out of the Brooklyn, OH office, with employees expected to work onsite on designated in‑office days each week. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. MS Dynamics 365 Technical Architect Seeking an experienced MS Dynamics 365 Technical Architect to lead the design, development, and implementation of enterprise level Dynamics 365 solutions (Sales, Marketing, Customer Service) in defining architecture, guiding development teams, and ensuring scalable, secure, and high-performing solutions that align with business goals and ensure IT architectural alignment with our corporate strategy, evolving business trends, and technology capabilities to arrive at better decisions that reduce IT cost, improve system flows, increase agility, remove duplicative functionality, and supports the management of risk associated with IT assets through the development and promotion of standards and policies. Lead: End-to-end architecture and solution design for MS Dynamics 365 solutions leveraging Dynamics 365 Solution Architect, Power Platform Solution Architect, Dynamics 365 Functional/Technical Consultant Expertise. Manage technical risks, performance optimization, and solution governance. Provide technical leadership and mentoring to developers and consultants. Lead application lifecycle management (ALM) and deployment strategies. Deliver: Define system architecture, integration patterns, security models and data strategies. Design and oversee customizations using C#. Net, JavaScript, Plugins, Custom APIs, PCF Controls and Power Platform. Architect Integrations with Azure Services, REST APIs, Service Bus, Logic Apps, and third-party applications. Collaborate: Team with agile teams (product owners, scrum masters, business analysts, developers, quality analysts), technical teams, and client stakeholders. MS Dynamics 365 Technical Architect I Responsibilities: - Acts as a subject matter expert (sme) to assist various IT areas to support efficiencies in overall design for implementations of new technologies and improvement of existing processes. Advises on best practices and ensures policy and procedure adherence. - Assists in the definition of the current and future state and the transitional plan. Focuses on the incremental improvements that move toward the future state looking for opportunities to streamline environments and remove redundancy. - Collaborates within teams, participates in reviews of all prospective software and hardware acquisitions. Evaluates compatibility with current architecture and supports future architecture roadmaps. Identifies architectural risks and proposes alternatives and solutions. Documents exceptions to architectural standards. - Assists in the review and revisions of new and existing IT standards and policies evaluating their importance. Assists in the development of architectural metrics and reports. - Maintains active awareness of IT industry including new developments, emerging trends, development tools and best practices. - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelors degree in Computer Science or related field or equivalent combination of training/education and experience. - 3 years proven ability to transfer technology to end user applications/environments. - Experience in cutting edge web collaboration design patterns and best practices Professional Certification(s): - NA Technical Skills and Knowledge: - Expert in one or more technologies (Microsoft, OpenSource, Database (relational, graph, Map, document, etc.). - Basic knowledge in infrastructure and networks with focus on security. - Basic understanding of various project methodology disciplines with basic knowledge of information and systems architectures, highly proficient in website architechtures. - Basic understanding of various data base platforms and data warehousing. MS Dynamics 365 Technical Architect II Responsibilities: - Translates overall IT roadmap into actionable processes. Supports the establishment of targeted architecture and develops standards for the organization covering all key domains (Application, Data, and Infrastructure). - Assists in the definition of the current and future state and the transitional plan. Focuses on the incremental improvements that move toward the future state looking for opportunities to streamline environments and remove redundancy. - Collaborates within teams, participates in reviews of all prospective software and hardware acquisitions. Evaluates compatibility with current architecture and supports future architecture roadmaps. Identifies architectural risks and proposes alternatives and solutions. Documents exceptions to architectural standards. - Reviews new and existing IT standards, and architectural plans modifies or creates standards and policies to support the future state. Develops architectural metrics and reports for the executive team, business and IT management. - Maintains active awareness of IT industry including new developments, emerging trends, development tools and best practices - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor's degree in Computer Science or related field or equivalent combination of training/education and experience. - 5 years proven ability to transfer technology to end user applications/environments. - 2 years of experience influencing technical direction in one of the following: application, data bases, or infrastructure. Professional Certification(s): - NA Technical Skills and Knowledge: - Expert in one or more technologies (Microsoft, OpenSource, Databased (relational, graph, Map, Document). - Experience with suite of IT applications including transactional, middleware integration, workflow, web based. - Solid knowledge in infrastructure and networks with a focus on security. - Solid understanding of various project methodology disciplines with solid knowledge of information and systems architectures, highly proficient in website architectures. - Solid understanding of various data base platforms and data warehousing. - Exposure to EA Framework such as FEAC, TOGAF or DODAF. MS Dynamics 365 Technical Architect III Responsibilities: - Translates overall IT roadmap into actionable processes. Supports the establishment of targeted architechture and develops standards for the organization covering all key domains (Application, Data, and Infrastructure). - Defines the current and future state and the transitional plan. Focuses on the incremental improvements that move toward the future state looking for opportunities to streamline environments and remove redundancy. - Collaborates within teams, participates in reviews of all prospective software and hardware acquisitions. Evaluates compatibility with current architecture and supports future architecture roadmaps. Identifies architectural risks and proposes alternatives and solutions. Documents exceptions to architectural standards. - Review new and existing IT standards, and architechtural plans modifies or creates standards and policies to support the future state. develops architectural metrics and reports for the executive team, business and IT management. - Maintain active awareness of IT industry including new developments, emerging trends, development tools and best practices - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelors degree in Computer Science or related field or equivalent combination of training/education and experience. - 7 years proven ability to transfer technology to end user applications/environments. - 3 years of experience influencing technical direction in one of the following: application, data bases, or infrastructure. Professional Certification(s): - NA Technical Skills and Knowledge: - Expert in one or more technologies (Microsoft, OpenSource, Databased (relational, graph, Map, Document). - Experience with suite of IT applications including transactional, middleware integration, work flow, web based. - Advanced knowledge in infrastructure and networks with a focus on security. - Advanced understanding of various project methodology disciplines with advanced knowledge of information and systems architectures, highly proficient in wesite architechtures. - Advanced understanding of various data base platforms and data warehousing. - Exposure to EA Framework such as FEAC, TOGAF or DODAF. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. #LI-CS1 #LI-HYBRID

Title: Application Security & DevSecOps Architect Location: Dublin, Ohio, 43017, United States Department: IT Architecture Full-Time Hybrid Job Description: Medical Mutual employees must submit their applications through MySource. This is a hybrid‑remote role based out of the Dublin, OH office, with employees expected to work onsite on designated in‑office days each week. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. The Application Security & DevSecOps Architect will lead the design and implementation of secure application architecture and DevSecOps practices across the enterprise, embed security throughout the software development lifecycle (SDLC) to reduce risk, improve resiliency, and enable scalable, secure software delivery and serve as the primary technical authority for application security, vulnerability management, and DevSecOps pipeline security. We're seeking candidates with these preferred technical skills: - Hands-on experience with application security tooling: - SAST (Snyk, Wiz, Checkmarx, Veracode, Semgrep, SonarQube) - DAST (Qualys, Burp Suite, OWASP ZAP, Invicti) - SCA, IaC scanning, container security tools - Strong knowledge of: - OWASP Top 10, CWE Top 25 - Threat modeling (STRIDE, PASTA, or equivalent) - API security and authentication (OAuth2, OIDC, SAML) - Experience with: - CI/CD platforms (Azure DevOps, GitHub Actions, Jenkins, GitLab) - Cloud security (AWS, Azure) - Containers and orchestration (Docker, Kubernetes) - Working knowledge of secure architecture patterns and Zero Trust principles Architect I Job Summary: Assists in the development of solution options to arrive at better decisions that will reduce IT cost, improve system flows, increase agility, and remove duplicative functionality. Supports the management of risk associated with IT assets through the development and promotion of standards and polices. Expertise may be concentrated in one or more domains. Responsibilities: - Acts as a subject matter expert (SME) to assist various IT areas to support efficiencies in overall design for implementations of new technologies and improvement of existing processes. Advises on best practices and ensures policy and procedure adherence. - Assists in the definition of the current and future state and the transitional plan. Focuses on the incremental improvements that move toward the future state looking for opportunities to streamline environments and remove redundancy. - Collaborates within teams, participates in reviews of all prospective software and hardware acquisitions. Evaluates compatibility with current architecture and supports future architecture roadmaps. Identifies architectural risks and proposes alternatives and solutions. Documents exceptions to architectural standards. - Assists in the review and revisions of new and existing IT standards and policies evaluating their importance. Assists in the development of architectural metrics and reports. - Maintains active awareness of IT industry including new developments, emerging trends, development tools and best practices. - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor's degree in Computer Science or related field or equivalent combination of training/education and experience. - 3 years proven ability to transfer technology to end user applications/environments. - Experience in cutting edge web collaboration design patterns and best practices Professional Certification(s): - NA Technical Skills and Knowledge: - Expert in one or more technologies (Microsoft, OpenSource, Database (relational, graph, Map, document, etc.). - Basic knowledge in infrastructure and networks with focus on security. - Basic understanding of various project methodology disciplines with basic knowledge of information and systems architectures, highly proficient in website architectures. - Basic understanding of various data base platforms and data warehousing. Architect II Job Summary: Acts in a leadership role that ensures the IT architectural strategy aligns with the overall corporate strategy and is tune with evolving business trends and technology capabilities. Assists in the development of solution options to arrive at better decisions that will reduce IT cost, improve system flows, increase agility, and remove duplicative functionality. Supports the management of risk associated with IT assets through the development and promotion of standards and polices. Expertise may be concentrated in one or more domains. Responsibilities: - Translates overall IT roadmap into actionable processes. Supports the establishment of targeted architecture and develops standards for the organization covering all key domains (Application, Data, and Infrastructure). - Assists in the definition of the current and future state and the transitional plan. Focuses on the incremental improvements that move toward the future state looking for opportunities to streamline environments and remove redundancy. - Collaborates within teams, participates in reviews of all prospective software and hardware acquisitions. Evaluates compatibility with current architecture and supports future architecture roadmaps. Identifies architectural risks and proposes alternatives and solutions. Documents exceptions to architectural standards. - Reviews new and existing IT standards, and architectural plans modifies or creates standards and policies to support the future state. Develops architectural metrics and reports for the executive team, business and IT management. - Maintains active awareness of IT industry including new developments, emerging trends, development tools and best practices - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor's degree in Computer Science or related field or equivalent combination of training/education and experience. - 5 years proven ability to transfer technology to end user applications/environments. - 2 years of experience influencing technical direction in one of the following: application, data bases, or infrastructure. Professional Certification(s): - NA Technical Skills and Knowledge: - Expert in one or more technologies (Microsoft, OpenSource, Databased (relational, graph, Map, Document). - Experience with suite of IT applications including transactional, middleware integration, workflow, web based. - Solid knowledge in infrastructure and networks with a focus on security. - Solid understanding of various project methodology disciplines with solid knowledge of information and systems architectures, highly proficient in website architectures. - Solid understanding of various data base platforms and data warehousing. - Exposure to EA Framework such as FEAC, TOGAF or DODAF. Architect III Job Summary: Acts in a leadership role that ensures the IT architectural strategy aligns with the overall corporate strategy and is tune with evolving business trends and technology capabilities. Assists in the development of solution options to arrive at better decisions that will reduce IT cost, improve system flows, increase agility, and remove duplicative functionality. Supports the management of risk associated with IT assets through the development and promotion of standards and polices. Expertise may be concentrated in one or more domains. Responsibilities: - Translates overall IT roadmap into actionable processes. Supports the establishment of targeted architecture and develops standards for the organization covering all key domains (Application, Data, and Infrastructure). - Defines the current and future state and the transitional plan. Focuses on the incremental improvements that move toward the future state looking for opportunities to streamline environments and remove redundancy. - Collaborates within teams, participates in reviews of all prospective software and hardware acquisitions. Evaluates compatibility with current architecture and supports future architecture roadmaps. Identifies architectural risks and proposes alternatives and solutions. Documents exceptions to architectural standards. - Review new and existing IT standards, and architectural plans modifies or creates standards and policies to support the future state. develops architectural metrics and reports for the executive team, business and IT management. - Maintain active awareness of IT industry including new developments, emerging trends, development tools and best practices - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor's degree in Computer Science or related field or equivalent combination of training/education and experience. - 7 years proven ability to transfer technology to end user applications/environments. - 3 years of experience influencing technical direction in one of the following: application, data bases, or infrastructure. Professional Certification(s): - NA Technical Skills and Knowledge: - Expert in one or more technologies (Microsoft, OpenSource, Databased (relational, graph, Map, Document). - Experience with suite of IT applications including transactional, middleware integration, workflow, web based. - Advanced knowledge in infrastructure and networks with a focus on security. - Advanced understanding of various project methodology disciplines with advanced knowledge of information and systems architectures, highly proficient in wesite architectures. - Advanced understanding of various data base platforms and data warehousing. - Exposure to EA Framework such as FEAC, TOGAF or DODAF. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

Title: Manager, Utilization Management Medical Director Location:Brooklyn, OH Department: Medical Director - Hybrid Job Description: This is a hybrid‑remote role based out of the Brooklyn, OH office, with the Manager, Utilization Management Medical Director expected to work onsite on four designated in‑office days each week. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Provides leadership to Assistant Medical Director teams based upon specialty or geographic area and performs utilization management review in area of expertise. Fosters continuous improvement in policies, processes, and all parts of the operations. Responsibilities: - Oversee physician’s utilization review process and determinations. - Participate in quality processes such as audits and quality improvement projects. - Provide leadership support to assistant medical directors - Ensure physician compliance with clinical goals through monitoring of care management performance. - Recommend changes and enhancements to current managed care, review guidelines, and clinical criteria based on clinical knowledge of health care delivery systems, utilization methods, reimbursement methods and treatment protocols. - Provide guidance to assistant medical director team in the coordination of quality care. - Performs other duties as assigned. Qualifications: Education and Experience: - MD or DO from an accredited medical school with an active, unrestricted (state) license to practice medicine in United States - Minimum of 5 years of established (clinical) care practice experience required - Physician reviewer experience in the insurance industry preferred Professional Certification(s): - Board Certification, in nationally recognized specialty (ABMS or AOA) is required. - Active Unrestricted license to practice medicine in US Technical Skills and Knowledge: - Foundational windows-based computer skills, including typing, word processing, presentation, and internet research skills. - Strong understanding of integration of evidence-based medicine and managed care principles. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

Title: Underwriting Administration Specialist Location: Cleveland, Ohio, 44144, United States Job Category: Underwriting Administration Requisition Number: UNDER001274 Full-Time Hybrid Department: Underwriting Administration Job Description: Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Under general supervision, supports health insurance sales and underwriting teams with administration of new and existing accounts in one or more of the following assigned market segments: large or small group, individual, government programs. Responsibilities: Underwriting Administration Specialist - Based on market segment assignment: - Reviews and processes new group and benefit changes in accordance with departmental policies and procedures. Ensures accurate coding of account worksheets and other documents in order to reflect proper rates and terms as well as compliance with underwriting regulatory requirements/laws. - and/or - Reviews and processes new submissions for all channels within the Small Group Market Segments, ACA Individual, Medicare Supplement and Short-Term Individual policies for completeness and compliance with underwriting regulatory requirements/laws, if applicable. - Responds to underwriting and administrative email and telephone inquiries. - Handles workflow distribution involving multiple departments and mailboxes per established procedures. - Establishes and maintains work logs and records needed for management reporting. - Performs other duties as assigned. Senior Underwriting Administration Specialist - Based on market segment assignment: - Reviews and processes new group and benefit changes in accordance with departmental policies and procedures. Ensures accurate coding of account worksheets and other documents in order to reflect proper rates and terms as well as compliance with underwriting regulatory requirements/laws. - and/or - Reviews and processes new submissions for all channels within the Small Group Market Segments, ACA Individual, Medicare Supplement and Short-Term Individual policies for completeness and compliance with underwriting regulatory requirements/laws, if applicable. - Manages workflow distribution including multiple departments, mailboxes, and systems. Ensures turnaround goals are achieved. - Identifies and assists with problem resolution within scope of authority. Interprets if escalation to management needed. - Trains more junior level administrative staff and conducts peer reviews/audits on processes. Leads status meetings and coordinates daily queue assignments. Prepares and summarizes work logs and records for management review. - Participates in the testing of the quoting and renewal systems to ensure rates are properly calculating, accuracy of exhibits, and quality assurance prior to release for external customers. - Documents workflows and processes. Updates underwriting procedures for new state and federal laws/regulations per corporate direction. Identifies continuous improvement opportunities. - Performs other duties as assigned. Qualifications: Underwriting Administration Specialist Education and Experience: - Associate Degree in Business or Healthcare Administration or related field or equivalent combination of experience, training, and education. - 3 years health plan sales or operations experience or equivalent customer service or office support experience in health care or financial services. Technical Skills and Knowledge: - Knowledge of standard office procedures and equipment operation (multi-function copier, multi-line phone, etc.) - Intermediate Microsoft Office (Word, Excel) and general database management/reporting skills. - Knowledge of health insurance products and underwriting operations. - Basic knowledge of general health plan regulations. - Good math skills. - Good customer service skills. Senior Underwriting Administration Specialist Education and Experience: - Associate Degree in Business or Healthcare Administration or related field or equivalent combination of experience, training, and education. - 5 years of experience as an Underwriting Administration Specialist or equivalent health plan sales or operations experience. Technical Skills and Knowledge: - Knowledge of standard office procedures and equipment operation (multi-function copier, multi-line phone, etc.) - Intermediate Microsoft Office (Word, Excel) and general database management/reporting skills and basic knowledge of health insurance underwriting systems. - Knowledge of health insurance products and underwriting operations. - Knowledge of standard health insurance underwriting formulas and related Company policies and procedures. - Strong math skills. - Strong customer service and training skills. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Title: Organizational Development Specialist Location: Cleveland, Ohio, 44144, United States Department: Organizational Development Job Description: - Full-Time - Hybrid - Locations Showing 1 location Cleveland, OH 44144, USA Job Details Description Note: Medical Mutual employees must submit their applications through MySource. This is a hybrid‑remote role based out of the Brooklyn, OH office, with employees expected to work onsite 3 designated in‑office days each week. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: We are seeking a dynamic Organizational Development Specialist to join Medical Mutual HR/OD team to help drive talent, culture, and performance initiatives, and succession across the enterprise. This role requires a strong blend of consulting, facilitation, and analytical skills. The position partners with leaders and employees at all levels, providing insights and guidance to support business objectives and enhance workforce effectiveness. An HR-informed perspective is highly valuable, enabling the specialist to deliver strong, effective coaching, design and lead impactful facilitation experiences, and influence organizational outcomes with credibility and empathy. This role also plays a key part in developing and delivering soft skills and leadership training, equipping employees and leaders to succeed in a dynamic, customer-focused environment. Experience with e-learning and instructional design is also important, supporting the creation of engaging, effective learning solutions across multiple delivery formats. Sr. Organizational Development Specialist Responsibilities: - Designs, develops and facilitates/co-facilitates complex OD and training programs/activities to employee- and leadership-level employees. Develops complex e learning content with e-learning tools. Conducts leadership-level OD and training programs. Utilizes OD assessment tools to support individual and team development. - Consults/partners with executive/senior business leaders and HR Business Partners to determine appropriate custom learning solutions (including team or individual development plans, coaching, and/or use of assessment tools). - Develops, facilitates, and supports company-wide OD programs. Examples include: Emerging Leaders, Lead Mentoring Program, Succession, Leadership Cohorts and Diversity and Inclusion initiatives. - Keeps abreast of changes and trends in talent, organizational development, and consulting practices; Surfaces meaningful recommendations for improvements that will positively impact the organization and its culture; Researches and analyzes the impact and effectiveness of new technologies (i.e., online learning tools, LMS, etc.), vendors and programs; and makes recommendations and manages ongoing process improvements. - Manages relationships with external vendors supporting the delivery of programs, including negotiating cost/budget and delivery expectations. - Performs other duties as assigned. Qualifications: Education and Experience: - Bachelor's degree in Business, Education or related field. - Master's degree in adult learning, organizational development, industrial-organizational psychology, human resources or related field preferred. - 5 years progressive experience as an Organizational Development Consultant or equivalent experience in adult learning or organizational development. - Demonstrated experience leading projects or teams. Professional Certification(s): - Certified Professional Trainer strongly preferred (or substantial progress towards designation). - Certified in behavioral assessment tools preferred. Technical Skills and Knowledge: - Advance knowledge of and the ability to apply advanced instructional design theories and adult learning principles. - Advanced knowledge of e-learning and content development software, such as Articulate, Captivate, etc. - Advanced knowledge of learning management software. Organizational Development Specialist II Responsibilities: - Designs, develops and facilitates/co-facilitates moderately complex OD and training programs/activities to employee-level employees. Develops moderately complex e learning content with e-learning tools. In conjunction with other staff, may support leadership-level OD and development programs. Utilizes OD assessment tools to support individual and team development. - Consults/partners with entry- to mid-level business leaders and HR Business Partners to determine appropriate OD and learning solutions (including team or individual development plans, coaching, and/or use of assessment tools). - Manages relationships with external vendors supporting the delivery of programs, including negotiating cost/budget and delivery expectations. - Gathers and utilizes feedback data to analyze impact of training and OD activities - Keeps abreast of changes and trends in talent, organizational development, and consulting practices; Surfaces meaningful recommendations for improvements that will positively impact the organization and its culture; Researches and analyzes the impact and effectiveness of new technologies (i.e., online learning tools, LMS, etc.), vendors and programs; and makes recommendations and manages ongoing process improvements. - Performs other duties as assigned Qualifications: Education and Experience: - Bachelor's degree in Business, Education or related field. - Master's degree in adult learning, organizational development, industrial-organizational psychology, human resources or related field preferred. - 3 years progressive experience as an Organizational Development Specialist or equivalent experience in adult learning or organizational development. Professional Certification(s): - Certified Professional Trainer strongly preferred (or substantial progress towards designation). - Certified in behavioral assessment tools preferred. Technical Skills and Knowledge: - Intermediate knowledge of and the ability to apply instructional design theories and adult learning principles. - Intermediate knowledge of e-learning and content development software, such as Articulate, Captivate, etc. - Intermediate knowledge of learning management software. #LI-GR1 #Hybrid Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Title: Financial Analyst Location: Dublin, Ohio, 43017, United States Department: IT Analyst Job Category: IT Analyst Requisition Number: ITANA001254 Full-Time Hybrid Job Description: Medical Mutual employees must submit their applications through MySource. Note: This is a hybrid role based in Dublin, OH, requiring three days per week on-site. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Financial Analyst III Job Summary: Provides analysis and accurate and timely financial information. Generates management reports and interfaces with corporate departments where necessary. Works with minimal supervision to solve problems, complete special projects, and conduct monthly activities. Acts as a best practice/quality resource for colleagues with less experience and guides others in resolving complex issues. Responsibilities: - Supports IT departments with generating forecasts and analyzing trends in various business areas. Duties also include taking into consideration actual performance, previous expenditures, and estimated expenses and income. - Creates financial models of "what if" scenarios for business planning decisions relative to new products. Completes financial analyses of costs for implementation versus ROI. - Works with guidance in on financial analysis situations and is recognized as an expert in the area within the organization. Demonstrates an understanding of when matters need to be elevated to management. Proposes solutions when bringing matters to the attention of management. - Performs other duties as required. Financial Analyst IV Job Summary: Provides complex analysis and accurate and timely financial information. Generates management reports and interfaces with corporate departments where necessary. Works independently to solve problems, complete special projects, and conduct monthly activities. Acts as a best practice/quality resource for colleagues with less experience and guides others in resolving complex issues. Trains and mentors less experienced staff members. Responsibilities: - Supports IT departments with generating forecasts and analyzing trends in various business areas. Duties also include taking into consideration actual performance, previous expenditures, and estimated expenses and income. - Creates financial models of "what if" scenarios for business planning decisions relative to new products. Completes financial analyses of costs for implementation versus ROI. - Works independently on the most complex situations analytical issues and is recognized as an expert in the area within the organization. Demonstrates an understanding of when matters need to be elevated to management. Proposes solutions when bringing matters to the attention of management. - Supervisory interactions with others in order to coach, mentor, and provide guidance on daily activities. - Performs other duties as required. Qualifications: Financial Analyst III - Bachelor’s degree in Finance, Business Administration - 5 years' experience working in financial analysis. - Advanced MS Office skills, including MS Access. - Proficient in the use of other automated accounting systems and an ability to serve as a training resource to junior staff members relative to the relevant systems. Financial Analyst IV - Bachelor’s degree in Finance, Business Administration. - 7 years' experience working in financial analysis. - Advanced MS Office skills, including MS Access. - Proficient in the use of other automated accounting systems and an ability to serve as a training resource to junior staff members relative to the relevant systems. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

Title: VP Pharmacy Management Brooklyn Department: Clinical Management Full-Time Hybrid Job Description: Location: Brooklyn, OH Hybrid, 4 days a week onsite Salary Grade: VPA Recruiter: L. Shinn **Medical Mutual employees must submit their applications through MySource. Develops and maintains strategies to manage pharmaceuticals that produce the best outcomes at the lowest cost. Creates plans for managing and measuring pharmacy utilization. Collaborates with various internal areas to plan, direct, and analyze pharmacy management and business development opportunities, analyze existing products, and identify emerging/leading edge products, services, or markets. Recommends a portfolio of market sensitive and cost-efficient products or services that support the Company's financial viability, marketability, maximum sales volume, and market share in accordance with corporate goals and objectives. Responsibilities: - Provides an overall definition of principal market requirements resulting in the formulation of the key strategies. Provides input to annual business plans for new/improved products, services, programs, business opportunities. - Drive pharmacy benefit strategy and design. PBM relationship owner and oversight of PBM performance. - Assesses the general effectiveness of cost reducing, service enhancing strategies, products, markets, and programs to increase business retention, ensure continued market responsiveness and improve customer satisfaction. - Utilizes innovative solutions and constructive thinking to recognize product and market trends/directions within the industry to keep the Company on the leading edge of new products or markets. Identifies emerging market trends that may lead to product/service innovation. - Collaborates with internal departments and other affected parties to help develop new/enhanced programs, products and services, promote overall business growth and manage pharmacy expense. Contributes to building physician incentive programs aimed at increasing pharmaceutical usage. - Represents the Company as an Executive Officer to key customers and other external contacts. Stays abreast of pharmacy and payer industry changes. - Negotiates and monitors contracts with outside vendorsincluding PBM. Reviews and approves budgets for functional operations under his/her control and administers his/her functional operations in accordance with budgeted goals and plans. - Performs other duties as assigned. Qualifications: Education and Experience: - Doctor of Pharmacy Degree. - 10 years progressive pharmacy leadership experience at a health plan or pharmacy benefit manager (PBM). - Experience with Medicare/Commercial/ACA. Professional Certification(s): - Registered Pharmacist in any state with unrestricted license and willingness to obtain Ohio License within 90 days. Technical Skills and Knowledge: - Comprehensive knowledge of Ohio Medicare/ACA, Pharmacy Benefit Management (PBM), managed care pharmacy, and health plan operations, and the ability to apply advanced concepts to Companywide strategy, policies, and procedures. - Knowledge of formulary management and Medicare Part B and D regulations and guidelines. - Knowledge of Request for Proposal (RFP) and Administrative Services Only (ASO) pharmacy sales. - Intermediate to advanced Microsoft Office (Word, Excel and PowerPoint) and pharmacy systems skills; basic proficiency with Visio, Access and QMF for Windows. - Ability to communicate and present to various internal and external audiences, including top management and board members. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Annual bonus and Long-Term Incentive - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

Title: Assistant Medical Director Location: Ohio, United States Department: Medical Director Job Category: Medical Director Requisition Number: ASSIS001174 Full-Time Remote Job Description: **Medical Mutual employees must submit their applications through MySource. **This is a remote-based role, and we are currently seeking candidates located in Ohio. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Provides clinical expertise to promote the delivery of high quality, cost effective, (member centric) medical care. Contributes to the achievement of clinical excellence; quality ratings improvement, appropriate inpatient and outpatient utilization, affordability, compliance, growth and focused improvement, and that initiatives are consistently implemented and successfully executed to achieve goals. Responsibilities: - Provides clinical expertise to the utilization review process and determinations. - Provides pre-determination reviews and reviews of claims determinations, providing clinical, coding and reimbursement expertise. - Ensures compliance with clinical goals through monitoring of care management performance. - Ensures the appropriate and most cost-effective medical care is received. - Recommends changes and enhancements to current managed care, review guidelines, and clinical criteria based on clinical knowledge of health care delivery systems, utilization methods, reimbursement methods and treatment protocols. - Assists in development and interpretation of medical policy, including medical necessity criteria, clinical practice guidelines, and new technology assessments. - Provides guidance to case management team in the coordination of quality care. - Performs other duties as assigned. Qualifications: Education and Experience: - Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited medical school. - Minimum of 5 years of established (clinical) care practice experience required. - Physician reviewer experience in the insurance industry preferred. Professional Certification(s): - Board Certification, in nationally recognized specialty (ABMS or AOA) is required. - Active unrestricted license to practice medicine in U.S state of residency. Technical Skills and Knowledge: - Foundational windows-based computer skills, including typing, word processing, presentation, and internet research skills. - Strong understanding of integration of evidence-based medicine and managed care principles. - Knowledge of health plan claims adjudication and utilization review processes preferred. Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes: A Great Place to Work: - We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset. - Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more. - On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters. - Discounts at many places in and around town, just for being a Medical Mutual team member. - The opportunity to earn cash rewards for shopping with our customers. - Business casual attire, including jeans. Excellent Benefits and Compensation: - Employee bonus program. - 401(k) with company match up to 4% and an additional company contribution. - Health Savings Account with a company matching contribution. - Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority. - Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits. - Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time. - After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption. An Investment in You: - Career development programs and classes. - Mentoring and coaching to help you advance in your career. - Tuition reimbursement up to $5,250 per year, the IRS maximum. - Diverse, inclusive and welcoming culture with Business Resource Groups. About Medical Mutual: Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us. There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans. We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing. #LI-CS1 #LI-REMOTE