• Monitor, maintain and evolve credit policies (origination and ongoing customer lifecycle management), including filters, rules and decision-engine calibrations. • Monitor key credit-cycle metrics such as approval rates, delinquency, losses, return/profitability, cohorts, policy stability and decision quality. • Develop and run tests to challenge current policies (experiments and incremental changes), covering the full end-to-end workflow: • hypothesis definition and test design • alignment with stakeholders (Credit, Data Science, Product, Engineering, Ops) • specification for implementation and production deployment • monitoring, result analysis and recommendation • definition of rollout, guardrails and follow-up plan • Act directly in origination decisions: approve/decline, limit setting and pricing. • Support the development and evolution of models, bringing business perspective to help prioritize, set objectives and evaluate performance in partnership with the Data Science team (e.g., features, performance analyses, validations, monitoring and iteration). • Produce analyses and materials that support decision-making (dashboards, deep dives, post-mortems), communicating clearly to both technical and business audiences.

• Own the accountability for the development and maintenance of clinical and reimbursement policies, ensuring perfect alignment with CMS regulations. • Serve as the authority on Medicare guidelines, specifically interpreting and operationalizing NCDs, LCDs, and general national coding guidelines. • Serve as the primary oversight for external vendor performance regarding policy monitoring and accuracy. Hold partners to world-class standards through data-driven performance reviews and collaborative workflow design. • Lead the implementation of AI initiatives to automate the monitoring of reimbursement policies. Utilize advanced LLMs (such as Claude, Gemini, and ChatGPT) to conduct regular deep research on ongoing industry trends. • Partner with the Configuration and Data Science teams to ensure that clinical and reimbursement policy intent is perfectly synchronized with technical adjudication. • Act as the strategic bridge between Clinical, Claims, and Compliance teams to ensure a unified vision of payment excellence.

• Gather, analyze, and document business requirements from stakeholders. • Translate business needs into functional specifications and requirements. • Conduct data analysis to identify trends, insights, and opportunities for improvement. • Collaborate with Operations, Service and Finance teams to design and implement solutions. • Analyze business processes and identify areas for improvement. • Prepare reports, dashboards, and presentations using tools such as Microsoft Excel and PowerPoint. • Support the creation of process maps, user stories, and functional specifications. • Facilitate meetings, workshops, and presentations with stakeholders. • Help validate that delivered solutions meet business requirements. • Maintain project documentation and status updates. • Support testing, validation, and implementation of new processes or changes. • Monitor project progress and ensure alignment with business objectives.

Role Description If you’re putting in full effort but still earning the same paycheck every week… that’s a problem. This opportunity removes the ceiling. You’ll work with clients who have already expressed interest in receiving help. Your role is to guide them through their options and help them get set up. Qualifications - Work ethic - Coachability - Desire to earn more Requirements - No income cap - No cold calling - Work from home - Paid based on results, not hours Benefits - Warm leads - Training - Ongoing support Company Description Global Elite Empire Consultants is a third-party recruiter, not an insurance agency. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.