Avēsis

• Responsible for selling commercial vision programs to employers in a specific geographic territory. • Drive new business growth and maintain sales goals. • Develop, manage, and expand distribution partner relationships for commercial vision and/or dental products. • Identify and pursue new sales opportunities within assigned territory. • Prepare, present, and deliver competitive proposals and bid responses to employer clients. • Coordinate cross-functional resources—including Sales, Account Management, Operations, Support, Finance and Senior Leadership—to achieve account objectives. • Generate accurate monthly sales and activity reports. • Collaborate with Account Management and Implementation teams to ensure smooth new client onboarding.

• Selling commercial vision programs to employers in a specific geographic territory. • Driving new business growth by selling ancillary benefits to Small and Mid-Group customers. • Developing, managing, and expanding distribution partner relationships to generate RFPs and bid opportunities for commercial vision and/or dental products. • Identifying and pursuing new sales opportunities within assigned territory to meet or exceed revenue and growth targets. • Preparing, presenting, and delivering competitive proposals and bid responses to employer clients. • Serving as the primary point of contact between prospects, clients, and internal teams throughout the sales lifecycle. • Focusing on retaining and expanding existing client relationships by identifying cross-sell and up-sell opportunities.

• Coordinate all aspects of regulatory and client audits (i.e., pre-site deliverables, mock audits, on-site visits, logistics, and written responses to audit reports and corrective actions) and coordinate across times to document and track completion to ensure audit success. • Synthesize audit-related information (i.e., scope, findings, recommendations, corrective action plans, and status) and provide Compliance and business operations leadership written and oral reports of ongoing and completed audits. • Simultaneously manage multiple audits and collaborate across multiple business areas to communicate gather necessary information within assigned due dates. • Develop compliance communications. • Problem solve and work closely with business partners on issue resolution. • Research, understand, and articulate regulatory and contractual requirements. • Educate business partners on regulatory audit processes as needed. • Manage, track and report data related regulatory and client audits and CAPs. • Coordinate with Legal Counsel as needed. • Perform additional duties as requested or required by management.

• Answer 40-60 inbound calls, responding to inquiries ranging from routine to moderate complexity. • Capture member information accurately and update systems with complete and concise data. • Ensure flexibility, stay organized, and comply with constantly changing programs and business rules. • Investigate issues that cannot be resolved at the time of initial call. • Collaborate with internal teams to research and follow up with the Member until a resolution occurs.

• Responsible for overall ownership of the EiPaaS application (Bridgegate) and its environment. • Ensure the accurate, timely, and compliant processing of 834 electronic files, provider files, and other items processed through the EiPaaS/Bridgegate application. • Maintain enterprise-wide oversight of all Bridgegate workflows. • Serve as the operational subject matter expert for electronic file integrations. • Ensure that all workflows function reliably to support downstream business processes. • Manage end-to-end processing of HIPAA-compliant healthcare EDI transaction sets, including 834 enrollment files. • Interpret and implement EDI files in accordance with ANSI ASC X12 standards. • Build, configure, and maintain templates for new 834 electronic files as business needs evolve. • Support onboarding of new partners and file configurations. • Maintain working knowledge of ANSI ASC X12 EDI standards and transaction set structures. • Monitor all EiPaaS/Bridgegate workflows, not limited to 834 transactions. • Serve as the primary point of contact for all EiPaaS related issues.

• Answer 40-60 inbound calls, responding to inquiries ranging from routine to moderate complexity. • Capture member information accurately and update systems with complete and concise data. • Ensure flexibility, stay organized, and comply with constantly changing programs and business rules. • Investigate issues that cannot be resolved at the time of initial call. • Collaborate with internal teams to research and follow up with the Member until a resolution occurs.

• The Senior Quality Assurance Analyst will coordinate and conduct comprehensive testing of IT systems, including scenario, regression, and automation testing. • Responsibilities include developing test plans, executing test cases, managing defects, and building automation frameworks. • The role involves working with tools such as Selenium, JMeter, SQL, and Azure DevOps, and requires expertise in Python, Java, and JavaScript. • This analyst will mentor junior team members and contribute to process development, project management, and continuous improvement initiatives. • Develop and execute test plans, strategies, and scenarios based on system requirements. • Design and automate test cases for UI, API, and database testing. • Perform functional, regression, integration, and performance testing. • Build and maintain automation frameworks and integrate them into CI/CD pipelines. • Collaborate on test environment setup and test data management.

• Provide daily administrative and operational support to the Account Management team, with a strong focus on vision retiree clients. • Assist in managing Key accounts alongside senior account managers. • Pull ID cards, plan documents, and group/member bills on request. • Complete Broker of Record (BOR) forms, change requests, and other documentation using Smartsheet and internal systems. • Monitor incoming service requests and ensure timely follow-up and resolution. • Help maintain account records, contact information, and task tracking across platforms. • Support project work as needed, such as open enrollment prep, reporting pulls, or group onboarding checklists. • Proactively identify administrative bottlenecks and work with the team to streamline processes.

• Develop analysis and regulatory interpretation of state and federal laws and regulations impacting Avēsis programs and products. • Coordinate and lead implementation activities critical to ensuring Avēsis exceeds expectations, outcomes and requirements associated with state or federal regulatory guidance, rules, requests, inquiries, and actions. • Interface with leaders and operational teams to provide applicable regulatory guidance and expertise. • Monitor, track and keep abreast of all applicable laws, regulations, and guidelines that pertain to the company. • Perform regulatory interpretation and analysis of new laws and regulations to develop written communications to advise the business on implementation of changes to comply. • Work with business owners to validate policies, procedures, and processes are developed, designed and implemented in accordance with relevant laws, regulations, and guidelines. • Identify and evaluate potential risks to the company including developing, communicating, and executing initiatives to promote awareness and understanding of compliance issues, applicable laws and regulations, requirements, and consequences on non-compliance. • Provide regulatory interpretive guidance in support of company initiatives and programs. • Interface with external clients and regulatory bodies to address inquiries, support audit or examination activities. • Proactively identify, address, and resolve compliance issues in partnership with business stakeholders.

• Build and maintain multi-level relationships with assigned health plan accounts. • Deliver exceptional customer service by managing established deliverables and handling ad hoc client requests. • Serve as the primary client liaison, leading meetings and engaging relevant departments for support. • Collaborate with internal subject matter experts and the Marketing department to develop client presentations. • Meet with clients throughout the year to provide program updates and stay informed about evolving market dynamics. • Coordinate with internal teams to create plans that improve quality scores (e.g., HEDIS, Stars) or adjust program costs as needed. • Lead internal account meetings and oversee the completion of deliverables. • Review client contracts to ensure compliance with terms and delegated functions. • Analyze monthly program financials, highlighting key trends and strategies to management. • Manage amendments and addendums to existing contracts. • Partner with the Implementation department to ensure smooth execution of new business and benefit changes or product expansions. • Maintain regular communication with clients to ensure high levels of customer satisfaction. • Provide regular updates to the Strategic Client Partner on account activity. • Identify and share meaningful insights from key accounts and market trends. • Develop annual strategic plans for each client, adjusting them as necessary throughout the year. • Collaborate with Business Development on cross-selling opportunities with existing clients.