• Acting as the primary conduit between legal/regulatory findings and the Core Network team, translating regional mandates into clear functional requirements. • Comparing local regulatory requirements against existing platform capabilities and collaborating with Core Engineers to identify necessary enhancements. • Creating high-level technical workflows and flowcharts for regulatory services (e.g., MNP, Lawful Interception) to guide engineering teams. • Defining business rules and data exchange requirements for Number Portability (MNP) and specifying functional needs for voice/SMS routing. • Defining data points and reporting frequencies required by local authorities, ensuring the engineering team builds the necessary data extraction tools. • Leading the definition of acceptance criteria to ensure that technical delivery successfully satisfies the specific regulatory hurdles of each country. • Managing the technical-regulatory checklist for various countries simultaneously, ensuring all dependencies are captured for the development sprint. • Coordinating with local central databases and external partners to ensure interworking specifications meet local quality-of-service mandates.

• Develop and manage process improvement initiatives for member and providers • Conduct, collect and analyze information from office site and/or medical record reviews • Monitor changes, corrections and clarifications in applicable regulatory/accrediting body requirements • Conduct continuing education to providers on STARS, HEDIS, and HCC Coding

• Supporting the CVS Health PBM Underwriting team by completing quality audits of financial documentation outlined in the contracts of CVS Health customers. • Aggregating discrepancies, identifying trends, and reporting findings to Underwriting senior leaders. • Ensuring adherence to underwriting guidelines, regulatory requirements, and risk appetite while continuously improving performance through actionable insights and data analysis. • Leveraging data to identify trends and opportunities for continuous improvement within the quality assurance (QA) framework for underwriting practices. • Designing and maintaining data-driven KPIs and quality scorecards to monitor underwriting performance, consistency, and compliance. • Analyzing underwriting data to detect patterns of procedural errors and developing actionable solutions. • Collaborating with underwriting, data science, and audit teams to implement quality improvement initiatives. • Driving automation and reporting tools to streamline quality reviews and enhance data transparency. • Presenting quality insights, metrics, and recommendations to senior leadership in a clear, data-supported format.

• Creating comprehensive and robust documentation and requirements that align with the Software Development Life Cycle (SDLC) phases and meet the customers' specific needs • Conducting workshops and meetings to gather requirements, prioritize features, and resolve conflicts, fostering effective stakeholder collaboration • Identifying the business needs and expectations of the customer and translating them into business change drivers and effective technical solutions • Utilizing business analysis methods and techniques to establish and document functional, non-functional, and transition requirements with end-to-end traceability throughout the project life cycle • Identifying potential risks and developing a strategy to mitigate them • Reviewing, documenting, implementing, and maintaining business processes for both the internal team and customers • Auditing project processes to improve results and customer satisfaction • Contributing to sprint planning sessions by providing insights into the feasibility and effort required to implement features • Facilitating clear, ongoing communication with all parties involved in a project to ensure a shared understanding is maintained