PacificSource Health Plans

• Manage the administration of direct compensation including the processing, recording and reporting of compensation-related actions related to both salaried and hourly paid employees. • Create consistent compensation guidelines and programs that match our compensation philosophy and organizational culture. • Create and analyze job descriptions and wage grade classifications. • Analyze and provide recommendations for new hire offers, promotions and internal transfers. • Provide advice to management on pay decisions, policy and guideline interpretation, and job evaluation, including the design of creative solutions to specific compensation-related matters. • Participate in, and conduct salary surveys, including the analysis of survey data and maintenance of salary survey database. • Keep abreast of legal, regulatory and legislative trends that relate to corporate governance and compensation. • Perform external market benchmarking analysis and internal equity analysis. • Ensure that compensation practices are in compliance with current federal, state and local compensation laws and regulations. • Assist Human Resources Team and other business partners throughout the organization with compensation-related issues.

• Manage the administration of direct compensation including the processing, recording and reporting of compensation-related actions related to both salaried and hourly paid employees • Create consistent compensation guidelines and programs that match our compensation philosophy and organizational culture • Create and analyze job descriptions and wage grade classifications • Analyze and provide recommendations for new hire offers, promotions and internal transfers • Provide advice to management on pay decisions, policy and guideline interpretation, and job evaluation, including the design of creative solutions to specific compensation-related matters • Participate in, and conduct salary surveys, including the analysis of survey data and maintenance of salary survey database • Keep abreast of legal, regulatory and legislative trends that relate to corporate governance and compensation • Perform external market benchmarking analysis and internal equity analysis • Ensure that compensation practices are in compliance with current federal, state and local compensation laws and regulations • Assist Human Resources Team and other business partners throughout the organization with compensation-related issues • Serve as a resource for hiring managers’ questions related to compensation • Responsible for providing and maintaining compensation and benefit-related data in Workday HRIS system, ensuring the system is updated with appropriate information • Keep abreast with trends and best practices in the field of compensation.

• Responsible for developing, administering, and maintaining compensation programs • Partner with the business to enable attraction and retention of talent • Evaluate requests to establish equitable and appropriate titles, salary ranges, pay rates, exemption assignments and benefit levels • Manages projects related to compensation strategic initiatives • Effectively collaborate with other members of the HR team • Create consistent compensation guidelines and programs that match our compensation philosophy • Analyze and provide recommendations for new hire offers, promotions and internal transfers • Participate in, and conduct salary surveys, including the analysis of survey data and maintenance of salary survey database • Ensure that compensation practices are in compliance with current federal, state and local compensation laws and regulations • Serve as a resource for hiring managers’ questions related to compensation

• Manage the administration of direct compensation including the processing, recording and reporting of compensation-related actions related to both salaried and hourly paid employees • Create consistent compensation guidelines and programs that match our compensation philosophy and organizational culture • Create and analyze job descriptions and wage grade classifications • Analyze and provide recommendations for new hire offers, promotions and internal transfers • Provide advice to management on pay decisions, policy and guideline interpretation, and job evaluation • Participate in, and conduct salary surveys, including the analysis of survey data and maintenance of salary survey database • Ensure compliance with current federal, state and local compensation laws and regulations • Serve as a resource for hiring managers’ questions related to compensation

• Responsible for developing, administering, and maintaining compensation programs which support our compensation philosophy. • Partner with the business to enable attraction and retention of talent. • Evaluate requests to establish equitable and appropriate titles, salary ranges, pay rates, exemption assignments and benefit levels. • Manage projects related to compensation strategic initiatives. • Effectively collaborate with other members of the HR team, and serve as a consultant to supervisors and staff across all locations. • Manage the administration of direct compensation including the processing, recording and reporting of compensation-related actions related to both salaried and hourly paid employees. • Create consistent compensation guidelines and programs that match our compensation philosophy and organizational culture. • Create and analyze job descriptions and wage grade classifications. • Analyze and provide recommendations for new hire offers, promotions and internal transfers. • Provide advice to management on pay decisions, policy and guideline interpretation, and job evaluation, including the design of creative solutions to specific compensation-related matters. • Participate in, and conduct salary surveys, including the analysis of survey data and maintenance of salary survey database. • Keep abreast of legal, regulatory and legislative trends that relate to corporate governance and compensation. • Perform external market benchmarking analysis and internal equity analysis. • Ensure that compensation practices are in compliance with current federal, state and local compensation laws and regulations. • Assist Human Resources Team and other business partners throughout the organization with compensation-related issues. • Serve as a resource for hiring managers’ questions related to compensation. • Responsible for providing and maintaining compensation and benefit-related data in Workday HRIS system, ensuring the system is updated with appropriate information.

Role Description Responsible for developing, administering, and maintaining compensation programs which support our compensation philosophy. Partner with the business to enable attraction and retention of talent. Evaluate requests to establish equitable and appropriate titles, salary ranges, pay rates, exemption assignments and benefit levels. Manages projects related to compensation strategic initiatives. Effectively collaborate with other members of the HR team, and serve as a consultant to supervisors and staff across all locations. - Manage the administration of direct compensation including the processing, recording and reporting of compensation-related actions related to both salaried and hourly paid employees. - Create consistent compensation guidelines and programs that match our compensation philosophy and organizational culture. - Create and analyze job descriptions and wage grade classifications. - Analyze and provide recommendations for new hire offers, promotions and internal transfers. - Provide advice to management on pay decisions, policy and guideline interpretation, and job evaluation, including the design of creative solutions to specific compensation-related matters. - Participate in, and conduct salary surveys, including the analysis of survey data and maintenance of salary survey database. - Keep abreast of legal, regulatory and legislative trends that relate to corporate governance and compensation. - Perform external market benchmarking analysis and internal equity analysis. - Ensure that compensation practices are in compliance with current federal, state and local compensation laws and regulations. - Assist Human Resources Team and other business partners throughout the organization with compensation-related issues. - Serve as a resource for hiring managers’ questions related to compensation. - Responsible for providing and maintaining compensation and benefit-related data in Workday HRIS system, ensuring the system is updated with appropriate information. - Keep abreast with trends and best practices in the field of compensation. Qualifications - 4 years’ experience in Human Resources. - Experience with job analysis/evaluation/wage grade structure design. - Experience with compensation research and data analysis as they relate to compliance requirements. - Experience with benefit administration. - Requires BS/BA degree in Economics, Finance, Business Administration, Human Resources Management, or related field. - SHRM-CP, SHRM-SCP, PHR, or SPHR Certification preferred and encouraged. Requirements - Ability to work well under changing priorities and deadlines with frequent interruptions required. - Thorough knowledge and practical understanding of human resources functions and state and federal employment regulations. - Broad understanding of the business and the role each functional area plays. - Ability to read and interpret company policies and procedures. - Analyze market survey data and identify trends. - Present information clearly and concisely. - Exercise tact and diplomacy and maintain confidentiality. - Proven experience in the use of Workday and Payfactors. - Use of software applications to conduct daily business functions required, super-user capability preferred. - Must have a passion for customer service (internal and external) and strong influencing skills. Benefits - Base Range: $65,296.83 - $111,004.62 Company Description - We are committed to doing the right thing. - We are one team working toward a common goal. - We are each responsible for customer service. - We practice open communication at all levels of the company to foster individual, team and company growth. - We actively participate in efforts to improve our many communities-internally and externally. - We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. - We encourage creativity, innovation, and the pursuit of excellence.

• Responsible for developing, administering, and maintaining compensation programs which support our compensation philosophy • Partner with the business to enable attraction and retention of talent • Evaluate requests to establish equitable and appropriate titles, salary ranges, pay rates, exemption assignments and benefit levels • Manages projects related to compensation strategic initiatives • Effectively collaborate with other members of the HR team, and serve as a consultant to supervisors and staff across all locations • Manage the administration of direct compensation including the processing, recording and reporting of compensation-related actions related to both salaried and hourly paid employees • Create consistent compensation guidelines and programs that match our compensation philosophy and organizational culture • Create and analyze job descriptions and wage grade classifications • Analyze and provide recommendations for new hire offers, promotions and internal transfers • Provide advice to management on pay decisions, policy and guideline interpretation, and job evaluation, including the design of creative solutions to specific compensation-related matters • Participate in, and conduct salary surveys, including the analysis of survey data and maintenance of salary survey database • Keep abreast of legal, regulatory and legislative trends that relate to corporate governance and compensation • Perform external market benchmarking analysis and internal equity analysis • Ensure that compensation practices are in compliance with current federal, state and local compensation laws and regulations • Assist Human Resources Team and other business partners throughout the organization with compensation-related issues • Serve as a resource for hiring managers’ questions related to compensation

• Independently plan, conduct, and manage prompt, thorough onsite and desk-top investigations of health care claims. • Thoroughly document investigative findings and actions to create comprehensive case files in accordance with established policies and procedures. • Proactively utilize available analytic resources to identify patterns of potential Fraud, Waste and Abuse, initiating audits when necessary. • Conduct fact-finding interviews with internal staff, external providers, patients and other relevant parties regarding medical and behavioral health services initiating investigations when necessary. • Utilize available Open Source Intelligence (OSINT) tools to verify provider licenses, research criminal history, disciplinary actions, financial assets and liabilities. • Attend and participate in regional FWA Task Force and other state or federal meetings. • Establish and maintain a comprehensive knowledge and understanding of current state and federal reporting requirements ensuring FWA reporting is received, summarized, catalogued, and disseminated to the appropriate agencies. • Ensure regulatory reporting is developed, accurate, and submitted timely. • Serve as an internal Subject Matter Expert (SME) on matters related to auditing and FWA. • Develop and conduct internal FWA related training. • Collaborate with government agencies during audits, investigations and Requests for Information (RFI). • Present and discuss case findings and recommendations in case review meetings with department and company management. • Participate in the development and presentation of FWA reporting for the Corporate Compliance Committee and the Audit and Compliance Committee of the Board. • Coordinate and manage the production of investigative materials in support of settlement negotiations.

• Guide strategic initiatives for the Provider Network Operations division, including network setup and maintenance, provider data integrity, provider education and service, contract implementation performance, provider-related claims, provider setup and audits, corrective action plan assessment and closure, and provider directory accuracy improvements. • Collaborate with Provider Reimbursement Insights and Analytics Team to ensure success in meeting objectives. • Develop, direct and execute efforts to meet Credentialing division objectives, ensuring compliance and operational excellence. • Develop and execute strategies for provider education and relationship management to enhance provider collaboration, engagement, and satisfaction within the Provider Relations Team. • Lead initiatives to ensure seamless integration and ongoing operational effectiveness of provider network platforms with legacy and emerging systems. • Collaborate with IT teams and operational leaders to identify interoperability gaps and develop solutions to enhance system compatibility. • Ensure integrated systems support compliance with state, federal, and NCQA standards, as well as organizational policies. • Develop automated workflows and processes that ensure accurate synchronization of data across all platforms and departments. • Guide efforts to improve functionality via the deployment of LEAN methodologies and resources.

Role Description This position is accountable for the Provider Network department’s core operational, data, and systems functions. This role will oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability. This position leads both department-specific and cross departmental planning and execution efforts, to maintain high levels of performance in enterprise level and Provider Network level key performance indicators. This position is responsible for all lines of business (Medicaid, Medicare, Commercial) and leads in strong alignment with the company’s strategic plan, vision, and values. - Guide strategic initiatives for the Provider Network Operations division, including network setup and maintenance, provider data integrity, provider education and service, contract implementation performance, provider-related claims, provider setup and audits, corrective action plan assessment and closure, and provider directory accuracy improvements. - Collaborate with Provider Reimbursement Insights and Analytics Team to ensure success in meeting objectives. Develop, direct and execute efforts to meet Credentialing division objectives, ensuring compliance and operational excellence. - Develop and execute strategies for provider education and relationship management to enhance provider collaboration, engagement, and satisfaction within the Provider Relations Team. - Lead initiatives to ensure seamless integration and ongoing operational effectiveness of provider network platforms with legacy and emerging systems. Foster partnerships with software vendors and internal stakeholders to optimize the interoperability of tools and streamline network operations. - Collaborate with IT teams and operational leaders to identify interoperability gaps and develop solutions to enhance system compatibility. - Ensure integrated systems support compliance with state, federal, and NCQA standards, as well as organizational policies. - Develop automated workflows and processes that ensure accurate synchronization of data across all platforms and departments. Guide efforts to improve functionality via the deployment of LEAN methodologies and resources. - Strengthen relationship management frameworks to ensure consistent communication and support for provider partners. - Actively participate in department strategic planning, execution, resource allocation, and performance monitoring. Work with executive leadership to ensure processes, technology, and people resources are in place to achieve success in both key performance metrics and efficiency/stewardship targets. - Oversee and guide provider collaborative efforts in coordination with other key departments and leaders. - Guide division functional leaders to develop business plans that ensure successful initiatives have a positive impact on the member, provider partners and PacificSource. - Design and deliver provider education programs to ensure understanding of network policies, reimbursement processes, and regulatory requirements. - Regularly assess provider feedback and implement enhancements to address pain points and improve relationships. - In partnership with Operations, IT, Health Services, Analytics, Finance and other departments, collaborate to maximize the alignment and value of various initiatives. - Oversee the planning of annual IT work plans, initiative work plans, financial budgets, and resource needs for the role of supervisory departments. - Develop and implement coaching and training programs with division leaders to foster team growth. Oversee resources and prioritization of those resources as new competencies are needed when the company grows and expands into new markets. - Responsible for hiring, staff development, coaching, and performance reviews. Provide feedback, including regular one-on-one meetings and performance evaluations for direct reports. - Responsible for overall employee engagement enhancement within Provider Network to include implementation of education/programs and other desired cultural enhancements. - Oversee division budgets and spending. Monitor spending versus the planned budget throughout the year and assess appropriate corrective actions as needed. - Actively participate in Manager/Supervisor meetings, PRISM walks, internal committees and other key department activities and disseminate information as appropriate. Qualifications - Minimum of 8 years in healthcare operations required. - Management experience required. - Expertise in provider reimbursement methodologies, provider relations, data management and compliance. - Experience developing, communicating, and executing strategy in a matrixed organizational structure. - Bachelor’s degree in business, health care administration, finance, or related field required. - Candidates with an associate’s degree and 2 years of relevant experience, or a high school diploma and 4 years of relevant experience, will also be considered. Requirements - Ability to develop and execute strategy. - Advanced knowledge of provider reimbursement and reimbursement methodologies, provider relations, or provider partnership activities in relevant markets and geography. - Ability to lead people in a matrixed organization structure and build high performing teams. - Proven collaborative interaction experience with provider leaders. Benefits - Base Range: $108,468.62 - $184,396.64. Company Description - We are committed to doing the right thing. - We are one team working toward a common goal. - We are each responsible for customer service. - We practice open communication at all levels of the company to foster individual, team and company growth. - We actively participate in efforts to improve our many communities-internally and externally. - We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. - We encourage creativity, innovation, and the pursuit of excellence.