• Own end-to-end CTM and Grievance performance — KPIs, compliance, QA strategy, and execution across the full ecosystem • Lead complex problem solving, using data and structured thinking to identify root causes and build scalable, enterprise-level solutions • Drive adoption of new tools and ways of working — including AI-enabled workflows — across teams that may be skeptical or stretched • Translate complaint, audit, and operational data into insights that drive upstream improvements and reduce risk before it reaches CMS • Build and standardize operating models, processes, and reporting that enable consistent, scalable, and audit-ready execution • Partner cross-functionally with Product, Engineering, Clinical, and Operations to influence benefit design, claims processes, and member experience based on what the complaint data is telling us • Lead large-scale operations while driving transformation — balancing near-term execution with longer-term process and technology improvements • Develop and coach leaders, building capability, accountability, and organizational strength in a fast-moving environment • Lead resource and capacity strategy, including budgeting and technology investments to improve efficiency and outcomes

• Lead development of the 5-Year Brand Plan across fiscal years, seasons, categories, and key franchises • Align plans with brand strategy, product lifecycle, and financial targets • Partner with Brand Leadership, Finance, and Merchandising to drive alignment and clarity on long-term priorities • Develop seasonal financial plans that ladder to long-term targets and KPIs • Provide strategic guidance on SKU productivity, assortment architecture, and lifecycle management • Support S&OP processes with clear reporting and actionable insights • Deliver executive-level insights on risks, opportunities, and performance trends • Influence and align cross-functional teams across Product, Merchandising, Finance, and Marketing

• Own medical, dental, vision, life, disability, retirement, wellness, leaves, and voluntary benefits for the U.S. and Canada • Evaluate competitiveness and make recommendations aligned to business growth and talent needs • Support global benefits alignment while accounting for regional requirements • Oversee day-to-day benefits administration, including enrollment, life events, and vendor management • Partner with Payroll to ensure accurate deductions, taxation, and reconciliation • Manage annual open enrollment end-to-end • Ensure compliance with ERISA, ACA, COBRA, HIPAA, FMLA, state/provincial regulations, and local labor laws • Manage audits, filings, plan documents, and vendor SLAs • Lead relationships with brokers, carriers, TPAs, wellness providers, and benefits technology vendors • Support RFPs, renewals, and cost negotiations • Translate complex benefits into clear, employee-friendly communications • Partner with HR and Communications on education, engagement, and change management • Monitor costs, utilization, and vendor performance • Prepare reports and insights for leadership, including trend, risk, and savings opportunities

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! This determines the psychosocial, environmental, and family economic dynamics that may affect the patient. Functions as the liaison and communicator with the patient, caregivers, multi-disciplinary team members, and post-acute care and third party payers. Confirms a clear, specific care setting order by the physician and applies hospital approved medical necessity criteria to review appropriate admissions and levels of care. Documents completed reviews in the hospital approved data set.To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties. This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion. Education Required - Graduate of an accredited school of nursing. Preferred - Bachelor’s degree in nursing. Work Experience Required - 1 year of hospital based experience in the delivery of patient care. Preferred - Experience in case management or utilization review. Certifications Required - Current Registered Nurse license in state of practice. Preferred - Commission for Case Manager (CCM), Certified Professional Utilization Review (CPUR), Certified Professional in Utilization Management (CPUM) or Certified Professional in Healthcare Management (CPHM) certification. Knowledge Skills and Abilities (KSAs) - Proficiency in using computers, software, and web-based applications. - Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. - Good knowledge of business/finance. - Ability to work a flexible work schedule (e.g. 24/7, weekend, holiday, on call availability) and travel throughout and between facilities. Job Duties - Directs and coordinates all admissions and transfers to, from, and within the hospital while coordinating with parallel processing of Environmental Services (EVS) and transport operations that tie into patient flow. - Facilitates professional relationships between unit leadership, operational coordinators, nursing staff, Regional Referral Center, medical staff, admitting office and interdisciplinary teams to provide patient/room assignment based on patient diagnosis, acuity, MD orders and patient flow. - Manages aspects of the planning process in anticipation of the patient’s movement through the healthcare system. - Interacts with managed care/ third party payers to obtain financial certification for appropriate reimbursement and to minimize reimbursement denials. - Manages the care of assigned patients through the healthcare system based on the patient’s individual needs, serving as a a contact person for the rehabilitation team, internal admissions team, clients and external sources to enhance outcomes. - Educates clients, family members or significant others, referral sources, hospital personnel, external payers, and internal/external case managers as to rehabilitation program benefits and services. - Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions and communication style. - Performs other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Physical and Environmental Demands 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. Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible. Duties performed routinely require exposure to blood, body fluid and tissue. The incumbent works in a patient care area; works in an area where patients enter; works directly with patients; and/or works with specimens that could contain diseases. There may be an occupational risk for exposure to all communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role. Are you ready to make a difference? Apply Today! Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website. Please refer to the job description to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C. Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or careers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities.