• Validates provider documentation for accuracy by reviewing and analyzing samples of coding and claims extracts compared to actual medical records • Develops education materials to assist physicians in accurately assessing patients’ overall health status • Provides feedback to providers on performance improvement opportunities; tracks and prioritizes projects to improve coding and documentation outcomes • Maintains a comprehensive tracking and management tool for assigned physicians within Alignments Healthcare provider network • Identifies issues, determines impact to risk adjustment models, and reports results timely to ensure that physicians remain in compliance • Collect, analyze, and share MRA performance data through clear presentations and detailed reports, including outreach priorities, HCC gap data, and encounter status insights for use through Joint Working Groups (JWGs) with internal and external stakeholders • Collaborate with internal and external coding, analytics, and clinical teams to ensure accurate and complete diagnosis coding and HCC Gap Closures • Presents progress and results to leadership on a routine basis • Assists with CMS Risk Adjustment Data Validation activities to ensure our external physicians and Alignment Healthcare is prepared for and will pass an audit • Regularly updates all Risk Adjustment materials with clinical and/or official guideline changes • Suggests, updates, and enhances clinical educational materials to assist in training physicians and clinical staff on Risk Adjustment Healthcare Programs including CMS-HCC Models, Clinician Chart Reviews, and Encounter Documentation • Suggests customizations of Risk Adjustment education for various audiences; Support Staff, PCPs, Specialists, Employees vs. contracted and Central Departments • Stays current on industry coding, compliance and HCC issues • Utilizes, protects, and discloses Alignment Healthcare patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards • Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies

Description and Requirements The Team You Will Join Join MetLife's Global Technology and Operations (GTO) team, where what you build truly matters. Here, innovation and collaboration drive everything we do- from developing best-in-class digital solutions to safeguarding customer and employee data. Whether you're transforming insights into customer-first strategies, advocating for people in life's most important moments, or simplifying how we serve millions worldwide, your expertise makes a lasting impact. We bring MetLife's purpose to life, shaping a more confident future. Let's build it together. The Opportunity The Operational Risk Consultant is responsible for supporting self-identified issue management for Global Customer Service and Operations partners across EMEA and the US. As a part of the GTO Business Controls team, supporting Global Customer Service & Operations, this is a great opportunity to contribute to the ongoing maturity and execution of the risk and control framework in a large, global institution and influence how the organization views risk. You will partner closely with business stakeholders and other corporate functions, including Global Risk Management, Internal Audit, Compliance, and Technology in the evolution and ongoing execution of the risk & control framework. The Business Controls, Global Customer Service and Operations Risk & Controls organization is focused on the assessment and monitoring of risk within Global Customer Service & Operations and understanding how the risk landscape continues to evolve over time to ensure that the risk framework is continually addressing emerging risk. Key Responsibilities - Support appropriate capture , management , and closure of self-identified issues (SIIs), risk acceptances, and risk events regionally in alignment with the Enterprise Non-Financial Risk Policy and Issue Management Standard. - Support Global Customer Service & Operations in maturing their view of controls and self-identification/validation of issues. - Deliver on issue management related goals/deliverables; implement best practices. - Support issue reporting needs for periodic management reporting. - Support the roll-out and the adoption of issue management process improvements and automation opportunities . - Partner to drive one-view of risk and applicable controls through alignment with Global Customer Service & Operations, Global Risk Management, Compliance, and Internal Audit. - A pply a continuous improvement mindset while instilling an experimentation and agile approach. - Support and communicate department strategy/vision effectively to business partners. - Coordinate and collaborate, while building strong relationships, with Customer Service & Operations regional partners, Risk and Compliance, IT and other GTO partners, and others as appropriate . - Perform other duties as assigned or required to support team risk management activities. Required Qualifications - 1-2 plus years of Risk Management or related Internal Audit/Risk & Control Environment experience, with progressive responsibility. - E xperience in issue manag e ment and best practices, including root cause analysis and developing action plans to mitigate control gaps. - Demonstrated track record of proactive communication to partners and leadership and ability to produce timely reporting for audiences at varying levels within the organization. - Strong interpersonal and teamwork skills - including oral and written communications, relationship building, collaboration, and influencing - across a broad range of levels in the organization. - Experience using data analytics and/or artificial intelligence tools. - Experience using 'GRC' tools. - Demonstrated ability to execute in an ambiguous and dynamic environment with a focus on delivery of outcomes. - Customer service orientation. - Ability to work independently and collaboratively. - Problem solver with the ability to translate information into actionable recommendations. - Demonstrated flexibility with shifting priorities and ability to manage multiple priorities simultaneously. - Ability to work flexible hours to support Customer Service & Operations partners globally. Preferred Qualifications - A minimum of 2 years in the financial services industry, preferably insurance. - Fluency (written and verbal) in a secondary language (French, Spanish, Arabic, etc.) - Experience in Fraud, Compliance, and/or Legal/Regulatory risk. - Bachelor's degree in accounting, Risk Management or related field. - Risk related or other certifications ( e.g. CPA/CIA/JD) - Knowledge of GRC technology: OpenPages, Archer, etc. - Understanding of latest risk trends in financial services. - Knowledge of Global Customer Service & Operations in a financial services environment. The expected salary range for this position is $59,000 - $99,300 . This role may also be eligible for annual short-term incentive compensation and stock-based long-term incentives. All incentives and benefits are subject to the applicable plan terms. Benefits We Offer Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, paid time off, paid holidays, volunteer time off, tuition assistance and much more! About MetLife Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces™, as well as the Fortune 100 Best Companies to Work For®, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East. Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us! MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics"). If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.

Title: Risk And Underwriting Senior Advisor Location: Chattanooga, Tennessee, Bloomfield, Connecticut, Bloomington, Minnesota, Denver, Colorado, Franklin, Tennessee, Morris Plains, New Jersey, St. Louis, Missouri, United States of America POSITION SUMMARY The Risk and Underwriting Senior Advisor role will be responsible for all pricing activities in supporting Sales and Account Management (SAM) for renewing and new sales clients. The Risk and Underwriting Senior Advisor will develop client-specific pricing strategies with competitive offers in the marketplace for all requests, including understanding and driving toward alternate pricing models. These requests may include Request for Proposals (RFPs), Direct Renewals, Coalition Support, and Market Checks. The expectation is that the Risk and Underwriting Senior Advisor will lead more strategic and complex pricing activities as well as provide training and support to Pricing Analysts and Senior Pricing Analysts for their activities. The Risk and Underwriting Senior Advisor will also provide pricing support for all ad hoc analyses (i.e. evaluating a change in formulary request, evaluating a change in retail network or retail arrangement request retail requests, evaluating a change in specialty arrangement request, etc.) with a potential financial impact. The Risk and Underwriting Senior Advisor will be required to gain in-depth knowledge of the PBM Industry, industry trends, and ESI-specific pricing methods. The Risk and Underwriting Senior Advisor will be required to follow the Pricing Guidelines provided by ESI’s Pricing Governance Team. ESSENTIAL FUNCTIONS - Provide pricing support to SAM for renewing and new sales clients by developing client-specific pricing strategies with competitive offers in the marketplace for RFPs, Direct Renewal and Market Checks. - Provide pricing support to SAM for ad hoc analyses which have a potential financial impact. - Provide support related to contracting process and install process for Commercial Division renewing and new sales clients. - Work collaboratively with internal partners to ensure we are proposing financial offers in alignment with Pricing Guidelines. - Ensure consistent approach to market and BA’s. - Support Strat Plan, Budget, and Forecast development of Rate Relief, Pass-Through Shortfall, and Gross Margin. - Provide training and support to other Junior/Senior Risk and Underwriting Analysts for their activities. - Solves complex problems. - Takes a new perspective using existing solutions. - Provides input on new solutions. - Works independently and receives minimal guidance. - Develops strong relationships with internal and external partners. - Represents the organization in providing solutions to difficult technical issues associated with specific projects. - Ensure pricing model accuracy by reviewing, analyzing and reporting for all pricing requests. QUALIFICATIONS - Bachelor’s degree in Economics, Statistics, Mathematics, Finance, or equivalent work experience. - 5+ years relevant work experience in pricing and/or underwriting. - Strong analytical and problem solving skills, advanced ability with Microsoft Office & Excel. - Entrepreneurial attitude; Ability to take ownership and deliver results; Experience in deal pricing and optimization or underwriting; Strong understanding of client analytics, financials, and value trade offs. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 106,700 - 177,800 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

• Execute Customer warranty claim evaluation and disposition in line with Warranty Policy and Standard Work • Interpret Customer NU Contract Warranty terms and conditions to determine claim validity • Review technical case resolution to support claim validity and disposition • Use Lean to drive culture, continuous improvement, and workstream productivity • Generate ideas to maximize Customer value and GE Gas Power business growth • Lead the new warranty governance framework operationalization and process improvements