Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role The Out of Network (OON) Mandate Arbitration Analyst will be responsible for researching, investigating and coordinating of document collections as well as preparing a summary of information related to Executive/Regulatory complaints, litigation, legal requests and other inquiries received related to the No Surprises Act (NSA). The OON Mandate Analyst will need to work with a variety of internal departments to prepare fulsome analysis for the assigned Paralegal (including outside counsel) and Executive/Regulatory team members. What You'll Do Job Responsibilities: - Prepare factual investigation files and research summary including root cause summary analysis as outlined on Litigation Document, Subpoena Request, Administrative Law Case Request, Commission Appeals/2nd Level Administrative appeals and NSA files (and/or other outside agency research request). - Analysis of data including but not limited to claim charts, medical authorizations, call records, provider requests, appeals, complaints, correspondence and other documents related to the requested case. - Summarize a justification for the legal, Exec/Reg, or other department regarding Horizon's claim handling, including but not limited to member benefits, contracts, payment methodology, mandate policies and procedures. - Provide reports as needed for the case. May include requests for informatics reports. - Search and review all phone calls (listening to each to determine how the call was handled) related to the case and summarize findings. - Request and provide copies of relevant documents, including but not limited to: Summary Plan Documents and Contracts, NSA negotiation and/or arbitration documents. - Review contracts for appropriate application of benefits/mandates. - Assess cause of complaint/appeal/legal case and determines the root cause of errors. Shares root cause with the appropriate Service Teams for re-education. - Recommends actions to the legal department on LDR cases based on case file review, i.e., overturn a denial due to an authorization that was on file, or claim payment that was not made correctly. - Other duties as assigned or needed by the Legal Department, by the Commission, Department of Banking and Insurance and/or another agency. - Attendance at Deposition Hearings, Administrative Law Hearings, Commission Meetings and other outside Committee meetings requiring subject matter expertise by the preparer of the files. What You Bring Education/Experience: - High School Diploma/GED required - Requires seven years of business experience which must include 4+ years of correspondence and/or telephone customer service experience screening, investigating and examining inquiries. - In lieu of seven years of experience, Bachelor's and 4+ years of correspondence and/or telephone customer service experience screening, investigating and examining inquiries is acceptable. - Healthcare industry experience required. - Experience in complex claims processing necessary. - Prior OON Mandate, Complaint/appeals handling experience preferred. - Ability to navigate various claims and service operations systems to obtain the necessary case information. Knowledge: - Knowledge of OON State and Federal Mandates required - Knowledge of HBCBSNJ complaints and appeals process preferred - Knowledge of insurance claim and membership systems required - Knowledge of medical terminology, COB, Medicare procedures required - Knowledge of NCompass and Nasco required - Knowledge of Claims Policy guidelines required - Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products, (Word, Excel, PowerPoint and Outlook). Skills and Abilities: - Requires the ability to understand and use language correctly - Requires the ability to read, understand and interpret written materials. - Requires the ability to analyze information and to understand and apply rules and procedures - Strong verbal and written communication including the ability to clearly communicate technical information to all levels of internal management and external stakeholder - Must be able to detail member/provider-specific issues through the development of individual correspondence for each case explaining all issues in a comprehensive, understandable fashion - Excellent interpersonal skills (i.e. active listening) - Strong research, investigative, analytical and problem solving skills - Requires the ability to handle confidential, proprietary, and privileged information with total discretion. - Ability to multitask - Time management skills Travel: - Some travel may be required. Why Horizon? At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we’d love to hear from you! Salary Range: $70,500 - $94,395 ​This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: - Comprehensive health benefits (Medical/Dental/Vision) - Retirement Plans - Generous PTO - Incentive Plans - Wellness Programs - Paid Volunteer Time Off - Tuition Reimbursement Disclaimer: Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

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 In the Senior Analyst - Reporting - Network Directory Development position, you will support the Network Provider Services department by producing files and reports in support of CVS Caremark’s clients. This position requires analytical and programming skills. In addition, it requires the ability to manage both long and short-term projects and assignments effectively and work collaboratively in inter-departmental settings to accomplish tasks and goals. In this role, you will design, code, test, debug, document, deploy, and support solutions that play a role in the support of member health. You will be responsible for: - Developing or assisting with logic, as needed, in SQL - Producing files used to support pharmacy directory creation and reporting - Collaborating in reporting and application development projects - Supporting activities such as programming, documenting, testing, debugging, and quality review - Working to improve data collection, preparation, accuracy, and reporting processes and other ad-hoc tasks and analysis as assigned - Ability to manage multiple priorities and meet deadlines while balancing support between work streams, logic development and deployment, identifying issues and documenting items requiring resolution Required Qualifications - Team player mentality - 2 years of experience in data file creation, data manipulation and gathering requirements - 2 years of experience using SQL - This individual must be able to work with both internal, CVS Health, and external, colleagues to gather requirements, develop layouts, provide analysis, and ensure partners’ reporting needs are satisfied from both a contractual and regulatory standpoint Preferred Qualifications - Experience with SSRS a plus - Experience with SSIS a plus -Experience with .NET a plus - Excellent analytical and communication skills - Knowledge of PBM / Healthcare industry a plus Education - Bachelor’s degree (verified) or equivalent experience Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $102,000.00 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: 05/05/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

• Translate the overarching enterprise strategy into tactical, executable data features and epics • Serve as the primary functional lead for the Data Integration and Data Quality pods • Define and document the core business rules, data mapping requirements, and acceptance criteria specifically required for features • Partner with dedicated Business Analysts (BAs) in a structured handoff, providing clear feature definitions • Manage and prioritize the feature backlog exclusively for the Data Integration and Data Quality pods • Document comprehensive data requirements, including integration logic and quality remediation to ensure assets meet enterprise standards • Act as the day-to-day liaison between the Lead Data Strategist and the execution pods • Participate in Agile execution ceremonies to represent the business intent and validate developed solutions

• Build executive-level presentations that drive the story of Ledgebrook forward • Coordinate with internal and external stakeholders to execute on key strategic initiatives • Conduct qualitative and quantitative research to build emerging business cases • Partner with leadership to develop presentations and content that outline Ledgebrook’s strategic vision and business results to our Board of Directors, investors, and business partners • Develop and exhibit a deep understanding of our enterprise-wide strategic initiatives and build business cases to influence the next stage of our journey • Understand and compile data to frame Ledgebrook’s performance to key stakeholders • Conduct market research to identify competitive intelligence, new product opportunities, and emerging trends in the E&S space • Lead and project manage cross-functional efforts with our underwriting, tech, operations, and reinsurance teams on a variety of go-to-market initiatives • Provide ad hoc support to key company events, such as partner summits and offsites