• Serves as main day-to-day contact with client • Works directly with client to identify needs and prioritize work • Oversees the work of more junior consulting staff to ensure client work is performed on time and at the highest level of quality • Actively participates in new business activity by assisting in presentations with prospects and reviewing proposals • Mentors more junior consulting staff • Works directly with clients and local broker partners to set up benefit programs • Coordinates local broker renewal activity and prepares renewal reports with recommendations for clients • Researches, drafts and presents global benefit benchmarking reports • Creates and maintains global benefit inventories for clients • Stays current on local employee benefits-related rules and regulations and advises clients on upcoming legislative changes • Assists in the development of global benefit philosophies and governance models • Works on a variety of ad-hoc projects and requests for clients as they arise

• Conduct medical necessity reviews for oncology and transplant-related services, both inpatient and outpatient • Collaborate with healthcare providers to gather and assess clinical documentation via phone and electronic systems • Apply evidence-based clinical criteria and guidelines to authorize services or refer cases to Medical Directors when needed • Navigate multiple computer systems efficiently while maintaining accurate and timely documentation • Work primarily in a sedentary setting involving extended periods of sitting, talking, listening, and computer use • Participate in occasional on-call rotations, including some weekends and holidays, per URAC and client requirements

• Conduct medical necessity reviews for oncology and transplant-related services, both inpatient and outpatient. • Collaborate with healthcare providers to gather and assess clinical documentation via phone and electronic systems. • Apply evidence-based clinical criteria and guidelines to authorize services or refer cases to Medical Directors when needed. • Navigate multiple computer systems efficiently while maintaining accurate and timely documentation. • Work primarily in a sedentary setting involving extended periods of sitting, talking, listening, and computer use. • Participate in occasional on-call rotations, including some weekends and holidays, per URAC and client requirements.

• Utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program • Review services to assure medical necessity and apply clinical expertise to assure appropriate benefit utilization • Facilitate safe and efficient discharge planning • Work closely with facilities and providers to meet the complex needs of the member • Gather clinical information and apply appropriate clinical criteria/guideline to render coverage determination/recommendation • Communicate with providers and other parties to facilitate care/treatment • Identify members for referral opportunities to integrate with other products and services • Consult and lend expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function