• Conduct IT Audits: Plan and execute audits of IT systems, applications, and processes to assess compliance with applicable regulations and frameworks (ISO 27001:2022, NIST, HIPAA, GDPR, FedRAMP, etc.) • Risk Management: Identify, evaluate, and document IT and security risks. Recommend and track remediation activities through resolution. • Security Monitoring: Support operational security activities by reviewing logs, network traffic, and alerts to detect and respond to potential threats. • Control Assessment: Evaluate the design and operational effectiveness of technical, administrative, and physical controls across global environments. • Data Privacy Compliance: Ensure adherence to global privacy regulations, including GDPR and related data protection requirements. • Reporting: Develop clear, actionable audit reports summarizing findings, risks, and recommendations. Present key insights to IT and management teams. • Continuous Improvement: Contribute to strengthening ZOLL’s overall security posture and compliance maturity through process optimization and control enhancement. • Collaboration: Partner with IT, Security, and Compliance teams to support remediation and drive risk management improvements.

• Perform and lead a variety of coding-related audits for providers and other entities • Review medical records to verify that complete and accurate diagnosis codes are captured in claims and retrospective chart review data • Communicate audit results and recommendations for improvement to providers when needed • Create and maintain processes for tracking audit results and outcomes of reviews • Identify, track, analyze and report on any trends revealed in audits • Develop and maintain centralized policy, process and compliance-related documentation and training resources to support the education of providers and internal stakeholders • Lead the development of educational materials and process documentation in a variety of mediums • Actively maintain up-to-date knowledge of coding guidelines and applicable state and federal regulations • Maintain active coding certification • Seek out emerging coding best practices • Serve as subject matter expert regarding correct coding practices • Collaborate with Risk Adjustment team to create SOPs and contribute to roadmaps for Risk Adjustment Coding initiatives • Onboard and train new Coding Auditors

• Audit Planning & Testing: Lead and execute comprehensive IT audits, including in-depth testing of IT General Controls (ITGC) across cloud infrastructure, enterprise applications, and the proprietary quoting platform. • Application & Data Integrity: Evaluate the design and operating effectiveness of application controls within key business processes (e.g., Finance, Operations, Marketplace). Perform detailed validation of Key Reports to ensure the accuracy, completeness, and reliability of data. • SOX Compliance Leadership: Drive IT SOX compliance efforts, including updating narratives, Risk and Control Matrices (RCMs), and process flowcharts, focusing on critical controls for a publicly traded, high-growth tech company. • Advanced Systems Review: Deeply evaluate security configurations, authentication processes, application security measures, and the controls surrounding new system implementations. • Strategic Risk Assessment: Partner with Technology and Business leaders to uncover technical risks, identify control deficiencies, and recommend practical, high-impact remediation strategies that align with Xometry's rapid pace. • Transformative Solutions: Go beyond compliance to surface critical issues and develop smart, actionable solutions that leverage technology to automate control processes and enhance business efficiency. • Data-Driven Auditing: Proactively utilize data analytics tools (e.g., Python, Alteryx) and internal platforms (e.g., AuditBoard) to continuously monitor controls, automate testing, and drive efficiency in audit procedures. • Compelling Deliverables: Prepare clear, concise, and persuasive audit workpapers and reports. Craft compelling audit deliverables—from scope definition to final reports—that effectively communicate risk and value to executive leadership. • Methodology Enhancement: Actively contribute to the development and enhancement of the IT audit methodology, programs, and risk assessment frameworks, integrating new technologies like AI into audit practices. • Industry Expertise: Stay current on industry best practices, emerging technologies (cloud, security), and regulatory changes (e.g., SOX, NIST, ISO 27001) relevant to a global, technology-driven marketplace.

Job Description Dependent on clinical discipline, the Case Manager / Health Coach coordinates appropriate care, resources and/or services of selected member populations. Provides guidance and promotes effective utilization and monitoring of health care resources to drive quality care for our members. Collaborates as needed with varied members of the healthcare team to achieve optimal clinical and/or resource outcomes. What You'll Do • Serve as a team member on a multidisciplinary team, coordinating care, resources and/or services for members to achieve optimal clinical and resource outcomes. • Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with members, family, internal partners and external services/providers on plans for treatment, appropriate intervention and/or discharge planning. • Develop a member-centric plan tailored to members’ needs, health status, educational status and level of support needs; identify barriers to meeting goals or plan of care • Utilize community resources and funding sources as needed in the development of the plan of care. • Perform ongoing monitoring and management of member which may include scheduled follow-up with member, discussion of plan with member, appropriate services/education to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plan/goals as needed, with contact frequency appropriate to member acuity. • Evaluate and facilitate care provided to members through the continuum of care (physician office, hospital, rehabilitation unit, skilled nursing facility, home care, etc). • Educate members and encourage pro-active intervention to limit expense and encourage positive outcomes • Effectively document all aspects of the plan from the initial assessment, development of the plan, implementation, monitoring, and evaluating outcome. • May outreach directly to members identified as high risk, high cost, or high utilization cases. • May review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exception or flex benefit options, where eligible. • May evaluate medical necessity and appropriateness of services as defined by department. • As needed, develop relevant policies/procedures, education or training for use both internally and externally. What You'll Bring • RN with 3 years of clinical and/or case management experience required. • Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties. • For some roles, additional specialty certification (i.e. CCM, CDCES) may be required. If so, incumbents must obtain relevant certification within 2 years of employment. Bonus Points - D-SNP experience What You’ll Get - The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community  - Work-life balance, flexibility, and the autonomy to do great work   - Medical, dental, and vision coverage along with numerous health and wellness programs   - Parental leave and support plus adoption and surrogacy assistance   - Career development programs and tuition reimbursement for continued education   - 401k match including an annual company contribution   - Learn more   Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $73,698.00 - $117,917.00 Skills Care Plan Development, Care Planning, Clinical Outcomes, Health Care, Healthcare Utilization Management, Medicaid, Nursing Fundamentals, Patient Advocacy, Patient Care, Patient Care Coordination, Patient Evaluations_____________________________________________________________________ JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.