Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. We serve employers, health plans, and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together, our team is on a mission to empower people to lead healthier lives. Learn even more about the work that drives us at personifyhealth.com. Responsibilities Ready To What You'll Actually Do ESSENTIAL DUTIES and RESPONSIBILITIES: The Director of Clinical Operations provides leadership and operational oversight for Utilization Management (UM), Case Management (CM), and Disease/Population Health Management (DM) programs. This role ensures care management operations deliver high‑quality, timely, and cost‑effective services in alignment with clinical standards, regulatory requirements, accreditation expectations, and organizational strategy. The Director partners closely with Clinical Compliance, Medical Directors, and operational leadership to drive performance, staff readiness, and continuous improvement Level I – Director, Clinical Care Management Operations (Operational Leadership) Care Management Operations - Oversee day‑to‑day clinical operations for UM, CM, and DM teams. - Ensure operational workflows meet productivity, quality, and turnaround time expectations. - Monitor staff performance, workload distribution, and case activity metrics. - Address operational barriers and escalate systemic issues as appropriate. People Management & Team Development - Supervise managers and/or clinical leads within Care Management. - Participate in hiring, onboarding, training, coaching, and performance management. - Foster team engagement and accountability while supporting consistent application of policies and procedures. Clinical & Program Oversight - Ensure care management decisions align with clinical criteria, plan language, and medical policy. - Support clinical components of cost management strategies and utilization optimization. - Maintain readiness for clinical operations components of NCQA and URAC reviews. Collaboration & Communication - Partner with the VP of Care Management on operational priorities and process improvements. - Communicate clinical updates, policy changes, and operational expectations to teams. Level II – Director, Clinical Care Management Operations (Program & Performance Leadership) Operational Strategy & Performance - Lead operational strategy across UM, CM, and population health programs. - Analyze utilization, quality, and outcome data to identify performance trends and opportunities. - Drive consistency and standardization across teams, states, and client populations. - Ensure care management operations are scalable and aligned with growth strategies. Program Development & Optimization - Oversee implementation and optimization of care management workflows, tools, and technologies. - Partner with Compliance and Medical Directors to operationalize regulatory and clinical requirements. - Lead corrective actions resulting from audits, performance reviews, or operational risk assessments. Leadership & Influence Serve as a clinical operations subject matter expert for senior leadership. - Provide input into strategic planning, budgeting, and staffing models. - Mentor care management leaders and build leadership bench strength. Senior Director – Clinical Care Management Operations (Enterprise & Strategic Leadership) Enterprise Operations Leadership - Set the long‑term vision for Care Management operations across products, clients, and lines of business. - Ensure operational excellence across UM, CM, and population health programs at scale. - Balance quality outcomes, member experience, regulatory readiness, and cost stewardship. Strategic Growth & Innovation - Lead enterprise initiatives related to care model evolution, automation, and performance optimization. - Sponsor cross‑functional initiatives that improve care coordination, utilization outcomes, and member impact. - Ensure Care Management operations support client retention, growth, and differentiation. Executive Partnership & Governance - Partner closely with executive leadership, Medical Directors, Compliance, Finance, and Client Services. - Represent Care Management Operations in enterprise governance, audits, and client discussions. - Develop future leaders and ensure succession planning for operational leadership roles. KEY COMPETENCIES: To work in the health industries and to work remotely, it has been demonstrated that those with computer skills work better in these remote job descriptions. Qualifications What You Bring to Our Team UPON HIRE, must have: - Basic computer literacy - The ability to work on multiple screens, and proficient typing skills. - Proficiency in software applications including, but not limited to, Microsoft Word, Microsoft Excel, and Outlook - Ability to speak clearly and convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others. - Ability to work independently and utilize written resources to problem solve. Training and understanding of AI tools like copilot and Claude helpful with the ability to learn and adapt technologies as they become available. - After training with our training department and 1.5 months ramp (3 months total), must have and be able to work in: - Teams on and off camera, SharePoint, Drives as needed, VPN, UM Web or Health Notes, El Dorado, Quick Links, GIAS, ADP, Confluence, Phone system with headset, Smartsheet—there may be additional programs as it relates to particular job duties - Knowledge of medical claims and ICD-10, CPT, HCPCS coding - Excellent verbal and written communication skills for upward and downward conversations - Knowledgeable of the Federal, State and ERISA regulations Level I - Strong operational knowledge of UM, CM, and disease management workflows - Effective people management and coaching skills - Ability to manage daily operational priorities and competing demands - Clear, consistent communication with clinical and non‑clinical teams Level II - Advanced performance analysis and operational problem‑solving - Ability to translate strategy into scalable workflows and metrics - Strong partnership skills across compliance, medical, and operational teams - Comfort leading through change and complexity Senior Director - Enterprise‑level operational leadership and systems thinking - Visionary leadership with strong execution discipline - Ability to align clinical operations with financial, regulatory, and strategic goals - Executive presence and influence QUALIFICATIONS: Level I - Active, unrestricted Registered Nurse (RN) license - Associate or Bachelor’s degree in Nursing required - Minimum 4–6 years of experience in UM, CM, DM, or hospital-based care management - Prior people management experience strongly preferred Level II - Active, unrestricted RN license - Bachelor’s degree required; Master’s degree preferred - 6–9+ years of progressive leadership experience in Care Management operations - Demonstrated success leading multi‑team or multi‑program operations - Certification in Case Management or Utilization Review preferred Senior Director - Active, unrestricted RN license - Bachelor’s degree required; Master’s degree strongly preferred - 10+ years of senior leadership experience in managed care operations - Proven enterprise leadership across UM, CM, and population health programs - Experience across multiple product lines (self‑funded, fully insured, Medicaid, Medicare) preferred Physical and Mental Requirements: - Ability to perform the essential job functions safely and successfully with or without reasonable accommodation, including meeting qualitative and/or quantitative productivity standards. - Ability to maintain regular, punctual attendance. - Ability to sit for 6-8 hours. - Constant use of computer keyboard and mouse; repetitive use of both hands. - Occasional to frequent twisting of neck; occasional bending of neck and at waist. This job description is not an exclusive or exhaustive list of all job functions that an employee in this position may be asked to perform. Duties and responsibilities can be changed, expanded, reduced, or delegated by management to meet the business needs of MedCom a Personify Health Company. Benefits The Highlights: - Competitive base salary and benefits effective day one - Comprehensive medical and dental through our own health solutions (yes, we use what we build) - Unlimited PTO—rest and recharge time is non-negotiable - Mental health support, retirement planning, and financial protection - Professional development with clear career progression and learning budgets - Mission-driven culture where diverse perspectives drive real impact on people's health Want the full picture? Visit personifyhealthbenefits.com to explore our complete benefits package, wellness programs, and other employee perks. Compensation: This position offers a base salary range of $118,560 - $137,280. depending on location, skills, and experience. You're eligible for our full benefits package starting day one. Our Commitment: Personify Health is an equal opportunity employer committed to diversity, equity, inclusion, and belonging. We cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive—because diversity is core to who we are and critical to our work in health and wellbeing. Stay Safe: Personify Health will never ask for payment or sensitive personal information like social security numbers during hiring. All official communication comes from verified company email addresses and or our secure applicant tracking system. Suspicious requests? Report them to talent@personifyhealth.com. View all legitimate openings at personifyhealth.com/careers.

• perform analysis by reviewing claims payments, policies, procedures and determine root cause for issues • assist with benchmarking, business process analysis, claims processing, testing updates and claims quality audits • ensure the appropriate identification of root cause through established intake process • perform claim analysis and summarize results with detail at the individual level and determine impacts • identify improvement opportunities based on analysis • act as a claims subject matter expert

Xylem is a Fortune 500 global water solutions company dedicated to advancing sustainable impact and empowering the people who make water work every day. As a leading water technology company with 23,000 employees operating in over 150 countries, Xylem is at the forefront of addressing the world's most critical water challenges. We invite passionate individuals to join our team, dedicated to exceeding customer expectations through innovative and sustainable solutions. The Operations Support Associate will be responsible for completing standard and non-routine business processes to support sales and branch operations ensuring that customer contracts, billing, invoicing and issues of any administrative nature are resolved in a timely fashion. This role can support various and multiple business units and is critical to ensure proper documentation, payment and resolution of customer issues. This role will also: - Able to perform non-routine tasks related customer issues and resolution - Ability to document tasks into process flows - Responsible for helping develop training material for customer processes and order entry - Strong collaboration with internal and external customers - May require on-site service center support based on service center team needs - Exception reporting for customer orders when purchase orders are flagged for non-compliance - Resolves issues from 3rd party processer of customers orders of limited complexity - Assists branch in maintaining appropriate inventory, generates purchase orders - Ability to create orders for quoted jobs or installation with multiple process in SAP of limited complexity but with unique job requirements - May be required to handle contract renewals and contract maintenance or changes of simple configuration or change of purchase order - Reviews autorenewals of contracts and supports contract additions identified by branch staff - Submission of invoices through appropriate vendor portal ensuring the uploads of invoices are compatible with customer payable system - May assist standard non-complex customer master data work flows Responsibilities: To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. - Create and maintain safe working environment and culture within the organization - Take care of internal and external customer needs and expectations - Demonstrates high impact culture through innovation, accountability and empowerment - Must be able to function in a team environment; usually works with direct supervision but can work independently - Task execution for area of responsibility up to levels defined in Xylem’s DOA policy Travel Requirements: - < 5% Education & Experience Requirements: - High school diploma or equivalent plus 2 years of applicable work experience or Bachelor’s degree with demonstrated capability in comparable work Skill Requirements: - Intra-departmental communication for purpose of alignment/information sharing/guidance/leadership - Able to executive tasks with high levels of autonomy; limited guidance required for complex tasks - Able to collaborate with other disciplines - Ability to understand concepts in execution, broader organizational impact, and strong organization skills - Understanding of general business concepts - Strong communication skills - Solid User of standard Microsoft Office applications (Outlook, Word, Excel, PowerPoint) - Strong ERP fluency in relevant systems - Strong understanding of typical IT business tools; adapt at learning new programs quickly (e.g. homegrown IT solutions but also new cutting-edge tools like Data Analytics) - Fluency in a Field Service and CRM application like (MS Field Service or MS CRM) Join the global Xylem team to be a part of innovative technology solutions transforming water usage, conservation, and re-use. Our products impact public utilities, industrial sectors, residential areas, and commercial buildings, with a commitment to providing smart metering, network technologies, and advanced analytics for water, electric, and gas utilities. Partner with us in creating a world where water challenges are met with ingenuity and dedication; where we recognize the power of inclusion and belonging in driving innovation and allowing us to compete more effectively around the world. At Xylem, you'll not only contribute to solving water issues but also have the chance to make a difference through our paid Volunteer Program, Xylem Watermark. We prioritize our employees' well-being through inclusion and belonging as well as our Employee Resource Groups (ERG). Proud to be an Equal Employment Opportunity (including disability and veterans) and Affirmative Action workplace, Xylem fosters an inclusive environment free from discrimination or harassment.   Please note that the information in this job description outlines the general nature of the position and is not an exhaustive list of duties. Xylem is dedicated to providing reasonable accommodations to enable all employees to perform their essential job functions. We reserve the right to modify this job description and assign additional duties as needed. Embrace the opportunity to be part of Xylem's transformative journey in shaping the future of water technology! #XylemCareers #GlobalImpact #WaterInnovation

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Provides plan benefit review, interpretation and systematic setup essential for online viewing and processing related to Customer Service, Claims, Enrollment, Billing and Reporting in support of internal and external partners. Fundamental Components: - Reviews benefit provisions to ensure compliance with state and federal mandates. Evaluation process may also include assessment of summary plan descriptions and other related documents prepared internally or externally by clients. - Develops and executes implementation strategy consistent with client expectations; Ensures strategy is administered in accordance with all performance guarantee arrangements. - Uses critical thinking and extensive knowledge of Meritain’s system and processes to evaluate impact of client requested exceptions and develops reasonable alternatives to satisfy client’s needs while minimizing impact on Meritain’s system and operations; Identifies, communicates and tracks cost sensitive items not included as part of the standard process and highlights them for consideration in the determination of rate adjustments or renewal activity. - Collaborates on review, analysis and development of recommendations for the design of complex account and benefit structures based on customers’ objectives and Meritain’s system. - Ability to utilize Meritain’s proprietary system for analytical coding of detailed customized plans rather than standard offerings. - Effectively manages implementation and provides direction to fellow team members ensuring success of overall implementation process. - Facilitating client facing review of plan setup walking through all benefits to assure alignment of benefit interpretation. - Solicits and assesses internal and external customer feedback to enhance continuous quality improvement on the implementation process (ie. System tools, resources, etc.) - Demonstrates Salesforce proficiency and understanding for cross functional communication and executive level status reporting. - Reviews coverage files at intervals throughout the first year of implementation to analyze for setup adjustments to align with claim processing reports to achieve higher levels of auto adjudication opportunities. Required Qualifications - 1-2 years Healthcare industry experience (Customer Service, Claims, and or Plan Build preferred) - This person should be highly organized and able to quickly prioritize multiple assignments with high quality results. - This person should have good communication skills with the ability to express complex concepts in a clear and concise manner. - This person should have a high attention to detail and accuracy while focusing on overall project deliverables. - This person should have the ability to remain flexible yet focused during stressful situations. - This person should possess good analytical and problem solving skills. Preferred Qualifications - 5 years healthcare industry experience with benefits Education - Bachelors Degree preferred or High School diploma/GED and equivalent work experience Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/24/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.