• Supporting SchemeServe customers by working in Scheme Builders, Post Live, and Obsessive Support • Handling support requests related to ongoing scheme management and updates • Providing quick, day-to-day support like uploading documentation or adding new users

Job Summary: The Medical Economics Analyst III is responsible for being proficient in identifying, quantifying and modeling opportunities to reduce medical costs within the market and presenting summarized analytical findings and recommendations to management. Essential Functions: - Identify and quantify cost savings initiatives to reduce medical costs within the markets - Build financial models to quantify impact of medical cost reduction initiatives - Assess overall health plan performance by analyzing medical cost, utilization trends, risk adjustment dynamics, revenue impacts, and identifying key drivers, outliers, and opportunities for optimization - Combine strong technical skills in SQL and Excel/Power BI with critical thinking, business acumen, and the ability to refine and edit analyses for accuracy and clarity - Extract, manipulate, and validate large healthcare claims datasets using SQL and Microsoft Excel/Power BI - Develop tools to efficiently identify new opportunities for cost savings - Partner with various departments within organization to discuss, develop and solution medical cost reduction initiatives - Evaluate the effectiveness of medical cost reduction initiatives - Present analytical findings and recommendations - Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization - Perform any other job duties as requested Education and Experience: - Bachelor’s Degree or equivalent years of relevant work experience is required - Advanced degree is preferred - Minimum of five (5) years of experience in healthcare analytics is required - Managed care experience is required Competencies, Knowledge and Skills: - Advanced knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data - Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is required - Advanced Excel proficiency (pivot tables, lookups, financial modeling, data validation) - Advanced SQL skills (data extraction, joins, aggregations, subqueries) - Ability to organize data in a way which facilitates inferences, conclusions and decisions - Strong analytical, problem solving and critical thinking skills - Ability to balance competing priorities - Demonstrated written and verbal communication skills Licensure and Certification: - None Working Conditions: - General office environment; may be required to sit or stand for extended periods of time Compensation Range: $83,000.00 - $132,800.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-EM1

Job Description Summary As a 340B Program Analyst, you will be responsible for analyzing and supporting the operations of the 340B Drug Pricing Program. Your expertise in data analysis, reporting, and program oversight will be instrumental in ensuring accurate and compliant utilization of the program. You will maintain program compliance, collaborate with various stakeholders to identify areas of improvement, and optimize cost savings while promoting access to affordable medications. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type​ Regular Cost Center CC005203 SYS - 340B Administration Pay Rate Type Hourly Pay Grade Health-24 Scheduled Weekly Hours 40 Work Shift Job Description Program Compliance: Maintain compliance with the 340B Drug Pricing Program regulations, policies, and guidelines. Conduct audits and regular assessments to identify and address any compliance gaps or issues. Data Analysis and Reporting: Collect, analyze, and interpret data related to drug purchases, inventory, eligibility, and utilization within the 340B program. Eligibility Verification: Collaborate with the 340B team to maintain processes for verifying patient eligibility for the 340B program. Monitor eligibility documentation and assist in resolving any discrepancies or issues to ensure accurate and compliant participation. Program Optimization: Identify opportunities to optimize the utilization and cost savings within the 340B program. Analyze data and trends to recommend strategies for improving program efficiency, maximizing drug discounts, and expanding program benefits. Vendor Management: Collaborate with third-party vendors, such as contract pharmacies or software providers, to ensure adherence to program requirements and optimize services. Training and Education: Develop and deliver training materials and educational programs to inform staff members and stakeholders about the 340B program Additional Job Description Bachelor's degree and two years relevant work experience; or an associate degree and three years relevant work experience; or a high school diploma or equivalent (GED) and four years relevant experience required. Relevant work experience may include accounting, bookkeeping, contract management, etc. A working knowledge of 340B legislation, and project management required. Must be able to operate with a high degree of independence with limited supervision and direction. If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

TCM Bank is in Tampa, FL. This is a remote opportunity. If living outside of the area, travel expectations would be at least 4 times (overnight travel) per year. Qualified candidates located in the states where we do business will be considered: AL, AZ, DC, FL, GA, IA, KY, MA, MD, MI, MO, NE, NC, OH, PA, SC, TX, & VA. SUMMARY: The Fraud Analyst is responsible for analyzing complex data, identifying emerging fraud trends, conducting detailed investigations, and implementing strategic fraud mitigation tactics across the credit card portfolio. This role combines analytical expertise with investigative skill, requiring independent judgment, strong communication abilities, and a deep understanding of fraud behaviors across the account lifecycle. The ideal candidate proactively identifies risk, strengthens fraud controls, collaborates with internal and external partners, and ensures customer protection while minimizing financial loss. DUTIES & RESPONSIBILITIES: - Analyze credit card authorization data and fraud trends to create, test, implement, and optimize fraud rules within TCM’s fraud monitoring systems. - Evaluate detection parameters, authentication rules, and authorization strategies to ensure optimal rule performance and minimize false positives. - Identify, interpret, and monitor fraud patterns across the account lifecycle; independently take action to reduce losses and increase recoveries. - Review compromised account alerts and carry out timely countermeasures to secure accounts and prevent loss. - Review alerts generated by fraud detection systems and fraud referrals, independently take appropriate action on all accounts or applications identified as suspicious, including general account maintenance. - Conduct end-to-end investigations, including large-loss and high-profile cases, and seek restitution when applicable. - Distinguish between types of fraud (e.g., fraudulent application, account takeover, synthetic identity, first-party fraud, scams) and resolve cases accordingly. - Use identity-linking tools/queue and investigative techniques to verify identities and assess involvement in suspected application fraud - Collect, analyze, and synthesize evidence into clear, professional investigative reports with findings and recommendations. - Prepare case filings that meet mandated regulatory reporting thresholds, file with appropriate agencies, and complete reimbursement documentation for vendors. - Perform quality reviews of fraud claim processing, review for cardholder participation and third-party vendor errors, document errors for corrective action by either party - Conduct outbound and inbound calls to verify activity, gather facts, and interview cardholders, merchants, and financial institutions. - Partner with operations and front-line employees to protect customer information and prevent future losses. - Maintain professional working relationships with law enforcement and peer institutions to support investigative efforts. - Support internal and external audits, providing documentation, testing support, and subject matter expertise. - Interpret loss trends, recovery outcomes, conduct root-cause analysis, providing performance summaries and trend analysis to fraud management. - Train new Fraud Prevention team members, providing job shadowing, coaching, and resource development. - Assist in developing internal job aids, investigative guides, and best-practice materials. - Collaborate with leadership to evaluate, test, and integrate new fraud tools, technologies, or enhancements. - Serve as backup for various interdepartmental roles as staffing requires. - Participate in required compliance and job-specific training programs; stay current on emerging fraud trends and regulatory expectations. - Demonstrate the ability to make independent decisions in ambiguous or evolving situations. - Perform other related duties as assigned. QUALIFICATIONS: - Ability to communicate effectively both verbally and in writing. - Minimum of 4 years of experience in the financial services industry- specific to Fraud. - Minimum of 2 years of experience in fraud investigation/analytics. - A four-year degree in finance, financial investigations, criminal justice, accounting, management information systems, or equivalent work experience - Knowledge of bank regulations (e.g. BSA, OFAC, Reg Z, Reg O, Chargeback Specifics). - Strong analytical, problem-solving, time management, interpersonal and decision-making skills. - High attention to detail. - Intermediate MS Excel skills with ability to perform functions including pivot tables, conditional formatting, and data analysis. SQL skills preferred. - Ability to analyze customer profiles and transaction history to interpret data and recognize non-obvious activity patterns. - Demonstrated ability to conduct creative and innovative research, retrieve and organize data to prepare reports and presentation materials. - Ability to provide feedback, coaching opportunities, and collaboration opportunities to partnering departments and third-party vendors. - Ability to conduct independent research of claims, examining the evidence, interviewing victims, and questioning potential perpetrators. - Experience with fraud monitoring strategies/rules. Falcon experience is a plus. - Ability to create reports and provide recommendations to management in a variety of mediums. - Self-motivated. Able to make independent decisions based on risk without leadership approval. - Thorough knowledge and understanding of fraud prevention and investigative concepts, reporting, practices, and procedures. - Strong interpersonal skills for interfacing with all levels of management and peers. TCM Bank, N.A. embraces the diversity of its applicants and employees and is proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status or any other characteristic protected by applicable law. The actual compensation offered to the candidate will be finalized at the offer and may be above or below the posted range due to skill level, experience, industry-specific knowledge, education/certifications, etc. The offer rate represents one component of TCM Bank's total compensation package. Employees will also receive several benefits as listed below. Other compensation for this position may include bonus eligibility in the TCM Bank Annual Bonus Plan. Benefits Offered: - Competitive medical, dental and vision benefits - 401(k) and Roth 401(k) retirement plans with company match - Flexible spending accounts (medical and dependent care) - Company-paid parental leave - Educational assistance - Company-paid continuing education credits - Paid employee assistance program - 12 paid holidays, including (3) Paid Employee Appreciation days each year, (2) Celebrate You Days for your Birthday & Anniversary, and company events. (More than your average company!) - Multiple time-off options for vacation, volunteering, or caring for yourself or loved ones. TCM Bank is in Tampa, FL. This is a remote opportunity. If living outside of the area, travel expectations would be at least 4 times (overnight travel) per year. Qualified candidates located in the states where we do business will be considered: AL, AZ, DC, FL, GA, IA, KY, MA, MD, MI, MO, NE, NC, OH, PA, SC, TX, & VA or will be willing to relocate (TCM does not provide relocation). No sponsorships available for this position. Principals Only. No Agencies Please.