The job profile for this position is Operations Lead Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. The responsibilities of an Operations Lead Analyst include monitoring daily request execution, reporting, and issue triaging for one or more owned client(s) upon request. Identifying operational or productivity enhancements, barriers, and opportunities for configuration and workflows. The Operations Lead Analyst will provide project and administrative support to leadership teams or Operations Advisors through escalation of issues, risks, and concerns as needed. Provides support to assigned projects by responding to inquiries or resolving complex issues using independent judgment, discretion, and general client knowledge. Routine communication of risk and status of owned clients and processes to leadership teams. What you'll do to make a difference: - Executes client requests and inquiries in alignment with SLAs and other contractual terms. - Monitors and triages client issues in alignment with SLAs and other contractual terms. - Adheres to all organizational SOPs and Compliance standards and provides subject matter input related to checklists and SOPs. - Assists with operational input related to new process development, including identification, research, and resolution of operational issues, and provides training and mentoring for new team members, offshore, and contingent employee resources. - Complies with ESI document and retention requirements. - Provides exceptional service to clients. - Collaborates cross-functionally and communicates effectively with necessary internal partners. - Communicates issues and status clearly and timely to leadership teams. - Maintains working relationships through collaboration with Account Management and clients for requirements intake and issue resolution; IT for system issues, setup, and testing; Product Teams to coordinate setup and resolve issues; Quality Teams for issue resolution and documentation; and Leadership Teams for initiative engagements and client health updates. What you need to be successful: - High School Diploma or GED required. Bachelor's degree preferred. - 3+ years of relevant experience required. - Strong knowledge of the healthcare and PBM industry and its products and services highly preferred. - Detail-oriented with strong analytical and problem-solving skills. - Ability to manage timelines and meet tight deadlines. - Ability to adapt in a dynamic work environment and make independent decisions. - Good organizational and prioritization skills with the ability to multitask. - Demonstrated ability to work with other departments and teams to resolve issues. - Experience with the use of ERP systems. - Proficient computer skills including all Microsoft office applications required. - Experience with data input and reconciliation. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 62,600 - 104,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Company Overview By Light Professional IT Services LLC readies warfighters and federal agencies with technology and systems engineered to connect, protect, and prepare individuals and teams for whatever comes next. Headquartered in McLean, VA, By Light supports defense, civilian, and commercial IT customers worldwide. Position Overview Our firm is seeking an experienced Operations Manager to oversee a mission-critical enterprise Identity and Access Management (IAM) program supporting a major federal agency. This IAM system is a foundational element of the agency’s IT infrastructure, ensuring secure access to resources across the organization. The role requires a leader who can manage operations with the highest level of rigor, ensure system uptime, and maintain compliance with federal security policies. Responsibilities - Lead and manage a multidisciplinary team of operations, support engineers, and administrators responsible for the IAM system’s availability, performance, and security. - Ensure the ongoing health and operational status of the IAM system, maintaining high availability, performance monitoring, and reliability. - Oversee incident response, root cause analysis, and problem resolution to minimize service disruptions and downtime. - Collaborate closely with the Site Reliability Engineering (SRE) team to implement reliability improvement strategies, monitoring solutions, and automation processes to enhance system uptime and performance. - Develop and optimize Standard Operating Procedures (SOPs) for the deployment, configuration, monitoring, and management of IAM resources. - Work with agency stakeholders to maintain and improve processes around user access, identity lifecycle management, and compliance. - Coordinate the implementation of new IAM features and upgrades in a manner that aligns with system reliability and security best practices. - Collaborate with security teams to ensure IAM systems adhere to all security requirements, including periodic vulnerability assessments, logging, and auditing. - Drive continuous improvement through automation, monitoring, and proactive issue identification to ensure system scalability and cost-effectiveness. - Ensure compliance with disaster recovery and business continuity requirements, including executing regular failover testing and recovery plans. - Monitor key performance indicators (KPIs) to measure and improve system uptime and service levels. Required Experience/Qualifications - 10+ years of experience managing mission-critical IT operations, preferably in a federal government or highly regulated environment. - 7+ years of direct experience in Identity and Access Management (IAM) operations or related fields. - Experience working in an Agile DEVOPS environment and SAFe. - Hands-on experience with automation tools (e.g., Terraform, Ansible, Puppet, Jenkins) and CI/CD processes or managing a team that performs automation. - Proven experience collaborating with Site Reliability Engineering (SRE) teams to enhance system reliability, optimize monitoring strategies, and automate issue resolution. - Strong leadership and communication skills to mentor and manage technical teams, as well as interface with senior agency officials. - Proven experience with implementing and supporting IAM Single Sign On (SSO) solutions. - Solid understanding of identity lifecycle management, authentication methods (SAML, OAuth, MFA), and directory services (LDAP, Active Directory). - Familiarity with federal IT security and compliance standards (FISMA, NIST SP 800-53). - Strong knowledge of system monitoring tools, incident management frameworks, and automation practices (e.g., using tools like Splunk or ServiceNow). - Experience with cloud services (AWS, Azure) and hybrid environments. - Excellent problem-solving and decision-making skills. Preferred Experience/Qualifications - Bachelor's degree in Computer Science, IT, or a related field. - Splunk certification. - Familiarity with IAM integrations with other enterprise security services. - Previous experience supporting federal identity governance initiatives. Soft Skills: - Demonstrate strong servant leadership, fostering a collaborative and high-performing team environment. - Thrive in a fast-paced environment, adapting quickly to new challenges and priorities. - Possess excellent communication skills and can effectively present to both technical and non-technical stakeholders. Special Requirements/Security Clearance - Must be able to obtain a Public Trust.

Overview The reimbursement coordinator of collections is responsible for collecting and managing account payments. This position is responsible for submitting claims and following up with insurance companies for payment fulfillment. This position is eligible for 100% remote but the employee must reside in a state where Enhabit currently operates. AK, AL, AR, AZ, CO, CT, FL, GA, ID, IL, IN, KS, KY, LA, MA, MD, MO, MS, MT, NC, NM, NV, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WY. Responsibilities - Complete billing tasks daily; ensure minimal write off of reimbursement dollars. - Monitor and maintain assigned accounts. - Collect all the necessary information to prepare insurance claims. - Submit clean claims timely and appropriately to various insurance companies; complete submissions electronically or by paper according to payor guidelines. - Research, correct, and resubmit rejected and denied claims. - Prepare appeals to denied claims. Qualifications - Must have a high school diploma or equivalent. - Two years of previous experience with home health, hospice, or Medicare billing and collections is strongly preferred. - Must have demonstrated competency with computers, including advanced typing skills. - Must be well organized and detail oriented with a desire and ability to maintain excellent records. - Must be able to multi-task and problem-solve in a high volume, interactive environment. Additional Information At Enhabit, we firmly believe our people are our greatest asset! Enhabit offers competitive benefits that support and promote healthy lifestyle choices. Some benefits, tools and resources include: - Comprehensive insurance plans - medical, dental, and vision - Generous paid time off – Up to 30 paid days off per year - 401k retirement savings plan with match - Basic life insurance at no cost to eligible employees - Employee scholarship program - Promote-from-within philosophy $16-$20/hr Enhabit Home Health & Hospice is an equal opportunity employer. We work to promote differences in a collaborative and respectful manner. We are committed to a work environment that supports, encourages and motivates all individuals without discrimination on the basis of race, color, religion, sex (including pregnancy or related medical conditions), sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, genetic information, or other protected characteristic. At Enhabit, we celebrate and embrace the special differences that makes our community extraordinary.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. This position is remote in Orange, CA. The Appeals & Grievance Coordinator is responsible for the day-to-day functions of the tracking and trending of all grievances, appeals, and complaints received within the Member Services Department. Acts as the primary investigator and contact person for member and provider grievances and appeals. GENERAL DUTIES/RESPONSIBILITIES : 1. Acknowledges the receipt of all grievance/appeals, and CTM (Complaint Tracking Module). 2. Gathers pertinent and relevant information from the member and/or provider regarding the grievance/appeal, determines the appropriate resolution of the grievance/appeal per standard policies and procedures; and notifies the appropriate parties of the resolution and ensuring that all internal processes are completed to resolve the issue. 3. Composes written correspondence to members in accordance to plan policy and CMS Guidelines. 4. Conducts non-biased, accurate, timely and comprehensive investigation of all the facts related to the grievance/appeal. 5. Thoroughly documents all action taken on behalf of the member or provider to resolve the grievance/appeal. 6. Ensures that all grievances/appeals are processed in adherence to the Centers for Medicare and Medicaid (CMS) guidelines and plan policy. 7. Prepares case files for Medical Director Review and external (including IRE) review of grievances/appeals as appropriate. 8. Prepares clear, objective, accurate and comprehensive case histories for presentation and consideration at committee meetings (including Board of Directors). 9. Maintains accurate and timely documentation, including complete files of all grievances/appeals. Prepares monthly and quarterly reports as requested. 10. Identifies training opportunities and potential system and process improvements relating to grievance/appeal data. 11. Participates in periodic review and update of grievance/appeal policies and procedures to reflect appropriate legal and CMS requirements as well as participate in periodic CMS Audit preparations and regulator meetings/interviews. 12. Other duties as assigned. Job Requirements: Experience: • Required: Two years’ experience in data entry and general office background. Three years of customer service experience. Minimum 1 year Member Services or similar experience. • Preferred: 2 years healthcare or insurance experience in a senior setting. Education: • Required: High School Diploma or GED. • Preferred: Associate degree (A.A.) degree. Training: • Required: • Preferred: Specialized Skills: • Required: - Knowledge of MediCal and Medicare Managed Care Plans. - Ability to Keyboard/Type 40+ words per minute and use the 10-key by touch. - Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. - Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; - Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. - Mathematical Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance. - Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations. - Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. • Preferred: Bi-lingual (English/Spanish) Licensure: • Required: None Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. 2 The employee is frequently required to walk; stand; reach with hands and arms. 3 The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl. 4 The employee must occasionally lift and/or move up to 20 pounds. 5 Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Pay Range: $44,790.00 - $67,185.00Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.