• Build and lead Zócalo Health’s prior authorization function, establishing operational workflows that support Enhanced Care Management (ECM), Community Supports (CS), Community Health Worker (CHW), Behavioral Health (BH), and Primary Care (PCP) services. • Design and implement scalable processes for authorization intake, submission, tracking, follow up, and reauthorization management to ensure services are approved and delivered within required payer timelines. • Hire, develop, and manage a team responsible for authorization operations, including conducting regular 1:1 meetings, coaching for performance and development, and setting clear expectations for quality, timeliness, and accountability. • Establish operational standards and documentation requirements that ensure compliance with Medi-Cal and managed care plan guidelines, including authorization documentation, submission timelines, and record accuracy. • Monitor and manage authorization workflows and work queues to ensure requests, reauthorizations, and referrals are processed accurately and efficiently. • Develop dashboards and reporting tools that track authorization turnaround times, approval rates, reauthorization timelines, and operational performance metrics. • Analyze trends in authorization outcomes and operational data to identify barriers, improve workflows, and reduce delays that impact patient care or reimbursement. • Partner closely with Clinical Operations, ECM, Community Supports, Product, and Revenue Cycle teams to ensure authorization processes align with care delivery, documentation requirements, and billing workflows. • Maintain working knowledge of payer authorization policies and program requirements to ensure workflows remain compliant as health plan guidance evolves. • Coordinate with health plans and payer representatives to address authorization issues, clarify requirements, and resolve escalations when approvals or timelines are at risk. • Lead ongoing process improvement initiatives that strengthen operational efficiency, reduce administrative burden, and support high quality service delivery. • Conduct internal audits and quality checks to ensure authorization accuracy, compliance with program requirements, and adherence to organizational standards.

• Revenue Generation & Market Development • Identify, pursue, and close new analytics engagements across Higher Education, Nonprofit, and Commercial sectors. • Develop and maintain a strong pipeline of analytics opportunities. • Lead discovery conversations to uncover business problems that analytics can solve. • Collaborate with Account Executives and Practice Leaders to shape and position analytics offerings. • Contribute to proposals, RFP responses, and solution design. • Own an annual revenue target tied to analytics services. • Expand existing accounts by identifying cross-sell and upsell opportunities (AI readiness, MDM, integration, governance, managed analytics services). • Client Delivery Leadership • Lead end-to-end analytics program delivery. • Serve as executive-facing delivery lead for analytics initiatives. • Translate business strategy into KPI frameworks and dashboard roadmaps. • Oversee data modeling, semantic layer design, and executive dashboard development. • Ensure projects are delivered on time, on budget, and with measurable outcomes. • Drive adoption and value realization from analytics solutions. • Analytics & Technical Oversight • Guide implementation across Power BI, Tableau, Salesforce Analytics, Snowflake, and related platforms. • Ensure alignment between analytics outputs and upstream data quality, governance, and MDM efforts. • Support AI-readiness initiatives by ensuring decision-grade data foundations. • Drive standardization of KPI definitions and reporting frameworks. • Practice Development & Leadership • Mentor analytics consultants and developers. • Build repeatable accelerators, templates, and delivery frameworks. • Help shape managed services offerings for analytics support and optimization. • Contribute to thought leadership, blog posts, webinars, and client-facing content. • Establish delivery standards, templates, accelerators, and repeatable frameworks. • Contribute to solution design for RFPs and client proposals. • Support go-to-market strategy for analytics and AI-enabled solutions. • Help build managed services offerings around analytics support and optimization.

• Conduct initial triage and telephonic case management at the outset of Workers’ Compensation claims. • Perform clinical assessments of injured workers to determine appropriate medical care and treatment pathways. • Complete initial assessment and required three-point contact in accordance with State of Florida procedures and emergency protocols. • Develop an initial case management care plan based on clinical findings and information obtained from the injured worker, employer, and medical provider. • Identify potential causation concerns or barriers to recovery and document findings appropriately. • Facilitate communication between injured workers, employers, claims professionals, healthcare providers, and rehabilitation specialists. • Monitor treatment plans to ensure adherence to state-mandated treatment guidelines and evidence-based medical protocols. • Address initial return-to-work capabilities with injured workers and providers, documenting updates in the case management system. • Maintain accurate and timely documentation of all contacts, interviews, and medical information in the claims management system. • Identify opportunities for cost-effective medical management and appropriate utilization of services. • Educate injured workers and their families about recovery expectations and care plans. • Maintain strict patient confidentiality and compliance with state and federal healthcare regulations. • Serve as a patient advocate, ensuring quality care and adherence to ethical and regulatory standards. • Participate in quality assurance initiatives, committees, and department activities as required. • Assist with training claims staff on identifying medical case management opportunities, as needed.

• Manage day to day operations of the Revenue Integrity department. • Personnel Management - Manage the operations and staff assignments. • Hire, coach, evaluate, discipline employees and track productivity. • Serve as the resource for Epic Connect on issues requiring Revenue Integrity’s expertise or assistance. • Coach, guide and develop staff related to their responsibilities. • Manage change and process improvement. • Schedule and lead meetings. • Delegate project tasks based on junior staff members' individual strengths, skill sets, and experience levels. • Utilize knowledge of Wellstar Health System to assess resources needed to complete projects and fulfill requests. • Coordinate all activities which have a system-wide revenue impact. • Direct all aspects of Revenue Management department in absence of Director. • Attend system-wide meetings that require Revenue Integrity’s attendance and input. • Build, lead, participate in interdisciplinary project teams. • Address billing and compliance issues that adversely affect revenue generating departments. • Ensure that all projects are delivered on-time, within scope.