Company : Highmark Inc.Job Description : JOB SUMMARY This job manages and coordinates the supervisory staff that has accountability for the case management, medical review, utilization review, quality management and/or health education team and programs. Monitors and evaluates the operational performance of overall departmental direction, leveraging analytics, regional market trends and utilization trends of members to set future direction and refine current state. Develops longer term plans that will improve utilization, quality and clinical outcomes based on market trends, legislative environment and company’s mission, vision and direction. The incumbent is responsible for the leadership, performance management for supervisory staff as well as company and department objectives, supporting providers in a variety of health care settings to appropriately identify members with chronic conditions and/or gaps in care that can be positively impacted related to quality and care costs. (note that health care settings could include, but not limited to, working in a physician’s office, visiting physician practices on a routine basis, working within a hospital setting and/or assessing and coordinating member’s care within the member’s home). ESSENTIAL RESPONSIBILITIES Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority. Assist in the development of goal-setting and establishing future direction of the operations of a combined case management/utilization management team and assist with operations planning and efficiency. Ensure overall compliance with applicable business process requirements, regulatory requirements and accreditation standards that support all lines of business. Serve as key resource to both supervisory staff and external sources on complex issues, departmental direction and future planning. Develop proposals to improve overall efficiency and managed care experience, utilization, quality and clinical outcomes. Collaborate with supervisor staff and providers for insights to inform future direction and refinement of overall operations. Collaborate with the appropriate cross- functional leadership and external entities to formulate new, innovative ideas to improve departmental performance and reduce costs while enhancing member experience. Other duties as assigned or requested. EDUCATION Required RN OR Bachelor’s or Master’s degree in Social Work Substitutions None Preferred Bachelor's Degree in Nursing EXPERIENCE Required 5 years of experience in Clinical, Utilization, Case and/or Disease/Condition Management, Provider Operations, Health Insurance, and/or other relevant experience 3 years in a management or leadership role Preferred None LICENSES or CERTIFICATIONS Required Clearances as required by specific practice or hospital, as applicable Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) (OR) Current Social Work license (e.g., LSW, LCSW, LMSW, LBSW). Additional states may be required depending on member area served. Preferred Certification in Case Management (CCM) Skills Proficiency in MS Excel and enhanced data and statistical analysis skills Excellent interpersonal/ consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization Broad knowledge of the health care delivery system including an understanding of health care costs drivers Excellent verbal and written communication skills including individual and/or group education/training Experience working with the healthcare needs of diverse populations and understanding the importance of cultural competency in addressing targeted populations. Self-directed; self-starter; ability to work successfully with indirect supervision and moderate autonomy Excellent organizational, time management and project management skills Ability to work in a fast paced, high visibility, high performing team environment that requires flexibility Ability to travel locally and work flexible hours in a practice or facility-based settings Ability to communicate effectively in more than one language, preferred Experience working directly with physicians in provider practice settings, members in a home environment or hospital discharge processes. Language (Other than English): None Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Never Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.Pay Range Minimum: $94,200.00 Pay Range Maximum: $151,000.00 Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Join us at NextStep Care– a place where you’ll be valued, recognized and rewarded for the vital work you do each day. We’ll surround you with a strong team and leadership that supports every aspect of your life – both inside and outside of our centers. And you’ll get to practice your passion in a non-profit, mission-driven organization that’s known for the highest level of care in our communities SUMMARY Responsible for serving as the Care Management Services’ member liaison and representative by ensuring the goals of the program and those of individual members are met through primary care enhanced case management. A primary function of this position is to complete member assessments. ESSENTIAL DUTIES AND RESPONSIBILITIES - Observes members in their home environment gathering medical, environmental, and psychosocial data for review by the multidisciplinary team. - Accepts referrals and ensures potential members are screened in a timely manner as required by organization and governmental policies. - Addresses member or caregiver concerns effectively and efficiently. - Assist in carepath developments, recommending HCBS services and incorporating roles for informal caregivers. - Records and documents member information completely and accurately in accordance with federal, state, and operational guidelines. - Works to preserve the essential role of the family and informal caregivers in assisting embers in meeting carepath goals and addressing social risk by following up on needs identified in data gathered from members/caregivers. - Makes recommendations to multidisciplinary team that address primary care needs - In conjunction with the Care Manager for Care Management Services and the multidisciplinary team, assists in removing barriers to primary and specialized medical care, to support optimal health and functional status. - Collborates with effectively with the Quality Department in resolving items needing additional information or clarification when identified on assessment review, to ensure standards of promptness and members needs are met in a timely manner. - Advocate for informed decisions by members and caregivers regarding their health stauts and options for treatment or care. - Promotes quality outcomes through effective collaboration with the Quality Assurance and education Coordinator, Assessment Coordinator, and Administrator to ensure effective implementation of education plans, initiative, or processes. - Utilizes technology to promote workflow efficiency and to facilitate data collection, management and analysis. - Takes call on a rotating basis as assigned. - Provides on-site assistance for all state surveys. - Reports corporate compliance concerns appropriately. - Reports privacy and security concerns appropriately. - Reports work time and business expenses in accordance with organizational guidelines. - Maintains prompt, accurate and secure documentation as it relates to member needs, contacts and plans. - Maintains prompt, accurate, secure documentation as it relates to member needs, contacts and plans. - Ensures appropriate documentation is filed promptly in members’ chart as outlined in Care Management. - Assists with Assessment Nurse Case Manager duties for other Care Management Services’ locations as needed - Promotes the image and reputation of the System by exhibiting servant leadership and providing direct and open lines of communication. - Contributes to the work of committees, workgroups, project management, and other collaborative efforts of the System. - Performs other duties as necessary to ensure the success of the System. SKILLS AND ABILITIES - Completes work in a timely, accurate, and efficient manner. - Ability to organize and prioritize assignments/responsibilities. - Maintains constructive working relationships by communicating and interacting effectively with supervisors, organizational leadership, peers and individuals inside and outside the Organization, in a positive, professional and respectful manner - Portrays a positive image of the organization and communicates guiding principles, mission, vision and values. - Completes work in a timely, accurate, efficient and thorough manner and is conscientious about assignments/responsibilities. - Consistently reports to work on time prepared to perform duties of the position. - Manages multiple deadlines with demonstrated flexibility in working with changing priorities. - Ability to work a demanding, primarily self directed work schedule. - Demonstrates good judgment and decision making. - Exhibits exceptional organizing and planning skills. - Ability to deliver excellent customer service, externally and internally as well as maintain customer confidentiality. - Ability to react effectively and calmly in emergency situations. MINIMUM QUALIFICATIONS ·Valid Georgia LPN license with 2 years of experience in the health and human services field ·Experience in social work, home and community based services, healthcare or geriatrics preferred. ·Valid Driver’s License. ·Reliable transportation. SUPERVISORY RESPONSIBILITIES None 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 associates of the organization. MATHEMATICAL SKILLS Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals. REASONING ABILITY Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram format. The ability to deal with problems involving several concrete variables in standardized situations. COMPUTER APPLICATION SKILLS This job requires proficiency with the following computer applications: Microsoft Outlook Microsoft Excel Microsoft Word CERTIFICATES, LICENSES, REGISTRATIONS Please see minimum qualifications PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the associate is regularly required to sit, talk or hear. The associate frequently is required to walk. Use hands to finger, handle or feel and reach with hands and arms. The associate is occasionally required to stand. Specific vision abilities required by this job include close vision, distance vision and the ability to adjust focus. EEO / M / F / D / V / Drug Free Workplace NextStep Care Facebook

• Lead TMF strategy, build, maintenance and governance across assigned clinical programs, ensuring alignment with BLA submission timelines and Health Authority inspection expectations while serving as the primary TMF point of contact. • Establish and maintain TMF governance standards, quality metrics, and executive visibility into TMF health, risk, and inspection readiness. • Define and enforce filing standards, naming conventions, metadata governance, and artifact classification aligned with the DIA TMF Reference Model and ICH-GCP requirements. • Develop and oversee TMF quality reporting, dashboards, and outputs to support proactive quality oversight and decision-making. • Create and support study teams in developing and executing Study TMF Filing Plans and Expected Document Lists (EDLs). • Implement and oversee a risk-based TMF Quality Control (QC) framework, including ongoing health checks, pre-submission, and pre-inspection reviews to ensure completeness, accuracy, and audit trail defensibility. • Maintain TMFs in a continuous state of inspection readiness and lead preparation for Health Authority inspections (e.g., FDA BIMO, Pre-Approval Inspections), including mock inspections and inspection narrative development. • Lead TMF gap assessments and structured remediation initiatives, prioritizing BLA-enabling programs and key regulatory milestones. • Author, maintain, and implement TMF-related SOPs, work instructions, training materials, and knowledge resources. • Provide strategic oversight of CRO and vendor TMF performance, including SLA monitoring, governance reviews, quality trend analysis, and TMF migration oversight. • Drive cross-functional accountability for TMF compliance, coach study teams and vendors on regulatory expectations, and serve as the TMF lead and escalation point during inspections.

Headway’s mission is a big one – to build a new mental health care system everyone can access. We’ve built technology that helps people find great therapists with the first software-enabled national network of providers accepting insurance. 1 in 4 people in the US have a treatable mental health condition, but the majority of providers don’t accept insurance, making therapy too expensive for most people. Headway is building a new mental healthcare system that everyone can access by making it easy for therapists to accept insurance and scale their practice. Headway was founded in 2019. Since then, we’ve grown into a diverse, national network of over 60,000 mental healthcare providers across all 50 states who run their practice on our software and have served over 1 million patients. We’re a Series D company with over $325m in funding from a16z (Andreessen Horowitz), Accel, GV (formerly Google Ventures), Spark Capital, Thrive Capital, Forerunner Ventures and Health Care Service Corporation. We want your time here to be the most meaningful experience of your career. Join us, and help change mental healthcare for the better. About The Role As Headway works to build a new mental healthcare system that everyone can access, we’re facing unique operational challenges and opportunities that come with growing and scaling at an unparalleled rate. We’re pushing the boundaries of the existing healthcare system so that we can fulfill our promise to providers, patients, and payers to create access to high quality providers across the nation. In order to do that, we’re building a world class operations team that enables efficiency, growth, and quality, and as a member of this team, you will have the opportunity to have a material impact on the trajectory of Headway and help define a function core to the livelihood of our business and the impact we deliver for our partners and clients. As a Clinical Operations Manager, you will lead high-impact, cross-functional initiatives that span teams and pods. You’ll operate as a thought partner to Clinical, Compliance, Legal, Data, and Operations leaders – helping shape objectives, influence priorities, and translate complex insights into actionable plans. In addition to owning critical operational workflows, you’ll design scalable systems, mentor team members, and drive initiatives that create durable, measurable impact across the organization. This role requires strong judgment, comfort with ambiguity, and the ability to drive alignment and execution across the organization. What you’ll do at Headway - Design and build foundations for a variety of 0-1 and scaling initiatives within the Clinical Operations function designed to improve the quality and compliance of services provided at Headway. - Collaborate cross-functionally to build, execute, monitor, and implement scalable products and processes that enable us to deliver on core business challenges. - Assess and analyze data to develop and determine strategies for accelerating progress, proactively identify areas for improvement, and deliver on roadmap priorities and team OKRs. - Build and manage a growing team to achieve these objectives. You’ll be great for this role if you: - 7+ years of experience in operational roles at high-growth companies, with some background in consulting, healthcare, business operations preferred but not required. - 2+ years of people management experience; you are a team builder that is passionate about growing and developing talent - Data is your first-language; you enjoy and are skilled at digging through complex data to solve ambiguous problems. - You thrive in the unknown, and seek out opportunities to dive into unfamiliar challenges, drive towards outcomes, and shape strategy. - You are operationally excellent, able to manage a large volume of moving pieces without breaking a sweat. - You are a collaborator that proactively partners across teams while holding teams accountable for execution. - You seek an environment that fosters individual growth through open-feedback and high-autonomy. - You are motivated by the opportunity to make an impact on one of our generation’s defining problems: affordable mental healthcare Compensation and Benefits: The expected base pay range for this position is $110,400 - $172,500 based on a variety of factors including qualifications, experience, and geographic location. We are committed to offering a comprehensive and competitive total rewards package, including robust health and wellness benefits, retirement savings, and meaningful ownership opportunities through equity. Compensation decisions are made holistically, ensuring fairness and alignment with market benchmarks while recognizing individual contributions and potential. Benefits offered include: - Equity Compensation - Medical, Dental, and Vision coverage - HSA / FSA - 401K - Work-from-Home Stipend - Therapy Reimbursement - 16-week parental leave for eligible employees - Carrot Fertility annual reimbursement and membership - 13 paid holidays each year as well as a Holiday Break during the week between December 25th and December 31st - Flexible PTO - Employee Assistance Program (EAP) - Training and professional development We believe a team's strength is in its people, and we cannot achieve this mission without a team that reflects the diversity of this problem – across race, ethnicity, gender, sexuality, age, national origin, religion, family status, disability, military status, and experience. Headway is committed to the full inclusion of all qualified individuals. As part of this commitment, Headway will ensure that persons with disabilities are provided with reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or receive other benefits and privileges of employment, please inform the recruiter when they contact you to schedule your interview. Headway participates in E-Verify. To learn more, click here. A notice to Headway applicants: To protect yourself against phishing and recruitment fraud, please note that Headway only accepts applications through our official careers page at https://headway.co/careers. Headway will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. All official communication will come from a @findheadway.com email address. If you are contacted by someone claiming to be from Headway via an unofficial channel, please do not share any information and report it as spam.