• Assesses patient's clinical need against established guidelines to ensure appropriate level of care • Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided • Coordinates and assists in implementation of plan for members • Monitors and coordinates services rendered outside of the network • Advocates for the member/family among various sites to coordinate resource utilization • Documents accurately and comprehensively based on standards of practice • Interacts and communicates with multidisciplinary teams to ensure continuity of care • Evaluates care by problem solving and participating in quality improvement programs • Outreaches to members identified by Horizon as needing Clinical Advocate services • Applies critical thinking and clinical expertise to maximize outcomes while interacting with members and their families

• Drive alignment between technology delivery and business priorities, ensuring execution, agility, and innovation • Organize and consolidate technology roadmaps into a unified format for executive review and communication across the enterprise • Ensure successful execution of technology priorities by streamlining processes, managing demand, and driving operational excellence • Partner closely with the CTO and technology leadership team to clearly define, measure, and ensure the delivery of value • Facilitate and continuously improve standardized processes, templates, and tools that enable consistent planning, tracking, and reporting • Track, monitor, and report progress against technology objectives and key results (OKRs) to support data-driven decision making • Develop and manage communications from the CTO office to key stakeholders, including senior executives, business partners, and technology teams

• Design, implement, and maintain the Operational Risk Management Framework in accordance with BACEN regulations. • Identify, assess, and monitor operational risk exposures, with emphasis on fraud and IT-related processes. • Develop and validate AI/ML models for fraud detection, anomaly detection, and operational risk quantification. • Build and maintain AI agents to automate operational risk workflows — such as loss event tracking, KRI monitoring, and incident reporting. • Establish and monitor Key Risk Indicators (KRIs) and conduct Risk and Control Self-Assessments (RCSAs) for ongoing risk tracking. • Collaborate with Data Science, Engineering, and Compliance teams to embed risk controls into product and process design. • Conduct scenario analyses and stress tests to evaluate operational resilience and inform management decisions. • Prepare clear, insightful risk reports and dashboards for senior management and regulatory audiences.

• Responsible for actioning day-to-day alerts related to fraud prevention, investigations, and dispute processing. • Monitor and analyze different types of information for decision making. • Assess risk levels and make approval recommendations for onboarding and payment processing limits. • Build trust with customers and internal teams through excellent experience and education. • Provide feedback on risk program improvements and assist in implementing those insights. • Stay informed of fraud trends and relevant regulations for maintaining an exceptional risk program. • Assist in developing fraud detection and risk management systems and tools.