Role Description We are looking for a Utilization Review Coordinator to provide Utilization Review administrative assistance to nurses, along with providing clerical support per guidelines for Initial Requests for referrals for specialists. - Follow workflow expected of UR Coordinator according to company and client protocols and production standards. - Coordinate scheduling of specialist referrals that have been approved by the UR Specialists. - Follow Rapid Response protocol established by client to authorize initial PT, initial diagnostics and initial referrals to a specialist upon receipt of referral on all new claims. - Document initial actions in Corrus using correct grammar, spelling, and sentence structure. - May act as back-up assistance for Triage Department and CMA Department. - Perform other duties as needed. Qualifications - High school diploma. - A minimum of one year of medical terminology/medical office experience. - Have a working knowledge of appropriate state’s Workers’ Compensation system and the statutes. - Medical terminology knowledge. - Experience dealing with medical provider offices. - Data entry proficiency and computer skills – Word, Excel. - Excellent organizational skills. - Detail oriented and motivated. - Ability to work in fast-paced environment and utilize critical thinking skills to ensure proactive outcomes. - Ability to effectively operate a personal computer and related claims and business software. - Good communication skills, both oral and written. - Team player. - Good attendance. - Good customer service skills. Benefits - Medical, dental, and vision plans to support your health and that of your family. - A 401(k) plan with employer matching. - Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees. - Paid holidays. - Life insurance and short-term and long-term disability coverage. - Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location. - Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Role Description The Member Support Admin is the operational backbone and frontline face of NSTXL’s 900+ member innovator ecosystem. This role sits at the intersection of technical customer success, data operations, and marketing support. You will manage the end-to-end of member support, from initial application vetting and technical platform troubleshooting to managing the inbound email queue and supporting engagement communications. The ideal candidate blends an empathetic, "customer-first" communication style with sharp technical aptitude, ensuring our members can seamlessly navigate our systems and access documents. Essential Duties and Responsibilities: - Member Correspondence & "Tier 1" Tech Support - Frontline Support: Manage the primary membership inbox; triage, troubleshoot, and resolve member issues regarding platform navigation, account access, and operational questions. - Ticketing & Triage: Track inquiry metrics (response times, resolutions) within the CRM and cleanly escalate complex technical, financial, or contract issues to internal teams. - Knowledge Management: Identify recurring member friction points and proactively update member-facing FAQs and internal resource guides. - Application Lifecycle & Data Hygiene - Onboarding & Renewals: Own the administrative intake, vetting, and data entry for new member applications and account setups. - CRM Administration: Maintain pristine member records in Salesforce/HubSpot, executing routine data to ensure organization and contact information is accurate. - Reporting & Analytics: Handle basic list management, audience segmentation, and pull routine reports to give internal teams visibility into member engagement. - Marketing Operations & Event Support - Campaign Execution: Build and validate audience lists for member announcements, newsletter distributions, and targeted marketing email campaigns. - Quality Assurance: Proof outbound communications prior to distribution to ensure flawless formatting and compliance with brand standards. - Virtual Events: Assist with the logistical coordination, list prep, and production support for live and virtual member webinars and forums. Qualifications - Bachelor’s/Associate's degree OR equivalent professional experience, plus 1+ years in an administrative, help desk, customer success, or membership operations role. - Demonstrated ability to learn new software quickly and guide non-technical users through system navigation and troubleshooting. - Exceptional written and verbal communication; comfortable translating complex processes into simple, friendly instructions. - High attention to detail regarding data entry and recordkeeping, with the ability to manage competing, deadline-driven priorities. - Self-motivated and disciplined to work effectively in a fully remote environment. Requirements - Hands-on experience with CRMs (Salesforce or HubSpot). - Familiarity with marketing automation or support ticketing tools (Zendesk, Mailchimp, WordPress, Marketo, etc.). - Experience supporting webinar production or virtual event execution. - Background or interest in government contracting, defense tech, or member-based ecosystems. Benefits - Health Insurance: Medical and dental – company pays 90% of premiums for individual coverage and for family coverage. - Vision Insurance: Fully covered. - Retirement Plans: 401(k) with employer match up to 4%. - Paid Time Off: Paid sick and safe leave, 10 federal holidays, floating holiday + your birthday, and generous vacation. - Other: Basic Life & AD&D policy company paid, Voluntary Life, Flexible & remote work structure, Wellness reimbursement plan & mental health support, Community sponsorships, Donation matching, Professional development allowance.

Role Description - Data Architecture & Design: - Design and maintain enterprise data architecture for structured and semi-structured healthcare data. - Define logical, conceptual, and physical data models. - Establish data standards, naming conventions, and metadata management practices. - Support event-driven and API-based data architectures. - Align data architecture with CMS interoperability mandates (FHIR, HL7). - Data Analysis & Insights: - Analyze large healthcare datasets to identify patterns, trends, and anomalies. - Support fraud, waste, and abuse (FWA) detection efforts through data analysis. - Develop analytical datasets and data marts for reporting and investigations. - Partner with business stakeholders to translate requirements into data solutions. - API & Streaming Integration: - Support data design for API Gateway integrations (MuleSoft or similar). - Ensure data consistency across Kafka streaming pipelines and batch sources. - Define data contracts and schemas for real-time data exchange. - Validate data transformations and mappings across source and target systems. - Data Governance & Quality: - Implement data governance, lineage, and stewardship practices. - Monitor and improve data quality, accuracy, and completeness. - Support data audits, validations, and remediation efforts. - Ensure compliance with HIPAA, CMS, FISMA, and NIST standards. - Reporting & Visualization: - Design and support reports, dashboards, and analytics for program integrity and operations. - Support ad-hoc data requests from investigators and oversight teams. - Collaboration & Documentation: - Work closely with architects, developers, QA, and security teams. - Participate in Agile ceremonies and data design reviews. - Maintain comprehensive documentation of data models, mappings, and architecture decisions. Qualifications - Bachelor’s degree in Computer Science, Data Science, Information Systems, or related field. - 5+ years of experience in data architecture and/or data analysis. - Strong experience with data modeling (ER, dimensional, normalized models). - Proficiency in SQL and data analysis techniques. - Experience working with large enterprise data environments. Requirements - Experience supporting CMS, Medicaid, or federal healthcare programs. - Knowledge of HL7 FHIR and healthcare data standards. - Knowledge of CMS CPI systems like PECOS; APS. - Understanding of CMS Medicare Program Integrity Manual. - Experience with API-driven data integration (MuleSoft preferred). - Familiarity with Kafka or streaming data platforms. - Experience with cloud data platforms like AWS. Benefits - The actual salary offer will carefully consider a wide range of factors, including your skills, qualifications, experience, and location. - C-HIT offers Healthcare Benefits, Remote Working Options, Paid Time Off, PTO cash-out, Training/Certification opportunities, Healthcare Savings Account & Flexible Savings Account, Paid Life Insurance, Short-term & Long-term Disability, 401K Match & Profit sharing, Employee Assistance Program, Paid Holidays, and much more perks and Voluntary benefits! - Employees of C-HIT shall, as an enduring obligation throughout their term of employment, adhere to all information security requirements as documented in company policies and procedures. Company Description C-HIT, a CMMI Maturity Level 5 company, focuses on delivering information technology and professional services to Federal and State agencies. "C-HIT is an EOE, including disability and veterans.”

• Own and lead the full implementation lifecycle for large, complex, or strategic clients from initiation through production deployment, ensuring all contractual deliverables are met on time and within scope. • Serve as the primary benefits configuration expert on client implementations, leading all discovery, requirements gathering, and configuration sessions. • Anticipate and proactively mitigate implementation risks; develop contingency plans and communicate issues to leadership with recommended solutions. • Review and validate benefit set-ups performed by junior analysts prior to client go-live. • Configure and maintain complex benefit designs, clinical rules, pharmacy networks, pricing structures, accumulators, and hierarchies across the RxSense platform. • Develop deep expertise in RxSense claims platforms and serve as an internal resource for platform capabilities and limitations. • Lead root-cause analysis on complex benefit set-up issues; develop and implement process changes to prevent recurrence. • Conduct impact analysis for platform changes, client requests, and identified issues affecting benefit configurations. • Build and sustain trusted advisor relationships with clients, serving as a consultative partner on benefit design strategy and platform optimization. • Represent Benefits Administration in cross-functional meetings, client steering committees, and escalation calls. • Partner with Client Services, Pharmacy Networks, UAT/QA, IT, Finance, and Clinical teams to drive flawless implementations and ongoing client satisfaction. • Provide mentorship, training, and day-to-day guidance to Benefits Administration Analysts and other team members. • Develop and deliver training materials for internal staff and private-label clients on benefit set-up requirements and platform best practices. • Act as an escalation point for the team on complex or ambiguous benefit configuration challenges. • Identify and lead initiatives to improve departmental workflows, documentation, and quality standards. • Assist the Director in developing and maintaining department policies, procedures, and best practices. • Contribute to strategic projects and product initiatives as a subject matter expert.