Role Description This position, under the guidance of the Vice President, Health Services is responsible for the operational oversight of the Utilization Management department. This includes: - Tracking and trending of utilization data - Development and update of policy and procedures - Regulatory reporting - Supervisory staff - Collaboration with internal teams and external providers Essential duties and responsibilities include: - Accountable for the functions of the Utilization Management department - Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines - Integrates quality improvement activities within utilization management - Communicates regularly with employees through participation in regular staff meetings to share information appropriate to their job functions and development - Serves as a resource to both lines of business in relation to Utilization Management - Plays an active role in both internal and external committees along with contract delegated responsibilities - Collaborates with network facilities to improve concurrent and discharge plans for our members - Performs retrospective review for the claims department - Assists in providing information for the appeals department - Provides information to reinsurance for members pending transplantation - Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy Qualifications - Current Oklahoma state RN license - Experience in Managed Care, Case Management and Concurrent Review - Previous experience in a supervisory role - CPHQ, CPUR and previous insurance experience preferred Requirements - Ability to communicate, both orally and written, and manage complex working relationships - Excellent organizational, leadership, problem-solving, and decision-making skills - Knowledge of Microsoft software programs including Word, Excel, PowerPoint and Power BI - Knowledge of quality improvement and utilization management Work Environment - Current work environment is remote, however, some state exclusions apply - Must have access to a reliable and secured internet connection source - Work environment must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy - This position will also be required to use reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and will adhere to all GlobalHealth privacy and security policies Travel - Travel may be required for this position Supervisory Responsibility - This position is in a supervisory role over Utilization Management leadership and staff Other Duties This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Role Description We’re looking for a hunter, a closer who can walk into a new market (residential and commercial), find the right people to talk to, and bring the deal home. If you know solar and energy storage, you love the chase more than paperwork, and you’re tired of asking permission to do your job well, read on. As Senior Regional Sales Manager for the Northeast, you own revenue growth in your territory. You’ll hunt and close net-new business across two channels: - Selling through distribution - Direct to installers It’s a complex, consultative B2B sale: within a single account, you might work an owner, a CFO, an engineer, and a sales team, and you’ll need to know how to navigate all of them to get to yes. What You’ll Own - Hunting and closing net-new distributor, EPC, and installer accounts across the Northeast. - Your territory strategy, end to end - who to target, how to break in, and how to grow the account. - Complex, multi-decision-maker B2B sales, from one-person installer shops to larger commercial firms. - Growth across both residential and commercial channels. - Hands-on product and sales training for your partners’ teams so they can sell and deploy our solutions. - Field intelligence back to product and marketing on positioning, pricing, and the competitive landscape. Qualifications - A proven hunter. - A documented track record of identifying, negotiating, and closing net-new technical B2B accounts, ideally with closing performance near the top of your field. - 5+ years in technical B2B sales or sales management. - Solar / energy storage industry experience. - Working knowledge of PV systems, inverters, and battery storage, and how the distributor and installer landscape works. - Self-direction. You run your own game, bring your own ideas. - Mobility. Based in the Northeast and able to travel roughly 50–70% within the region for client visits, site evaluations, and trade shows. - Education. A bachelor’s degree in business, marketing, or a technical discipline is a plus. Requirements - Energy storage sales specifically. - An active network of installers, EPCs, and distributors in the Northeast. Benefits - Uncapped commission. - Tiered and uncapped. - Real autonomy. - Work from home, hit your number and you run your own playbook. - Your ideas get implemented. - Bring a strategy and you’ll get the support to execute it. - Room to grow. Expand your territory, grow into Senior RSM or Sales Director, or stay an individual contributor with a bigger book at a company positioning for significant growth. Company Description Fortress Power is an established, profitable solar and energy storage company entering its next phase of growth. We sell battery storage, the most sophisticated component of a modern solar system, and effectively its brain, along with the broader product line, through solar and electrical distributors, EPCs, and installation companies. Our Regional Sales Managers are the people who grow that business in the field.

Role Description The Insurance Verification & Benefit Manager will oversee various workflows related to insurance verification and benefits management. - Oversee insurance verification, eligibility determination, and benefits investigation workflows across commercial, Medicare, Medicaid, and managed care payers. - Verify patient insurance coverage using payer portals, clearinghouses, and EDI 270/271 real-time eligibility transactions. - Identify and resolve coordination of benefits issues, coverage gaps, and eligibility discrepancies prior to service delivery. - Evaluate and annotate AI-generated eligibility verification outputs for accuracy, completeness, and payer compliance. - Develop and document SOPs for eligibility and benefits verification workflows. - Monitor KPIs including verification accuracy rates, front-end denial rates related to eligibility, and turnaround times. Qualifications - 5+ years of experience in insurance verification, eligibility and benefits management, or front-end revenue cycle operations, with at least 2 years in a management role. - Expert knowledge of EDI 270/271 transactions, payer portal navigation, and real-time eligibility tools. - Strong familiarity with Medicare, Medicaid, and commercial payer eligibility requirements and benefit structures. - Proficiency with Epic, Cerner, Meditech, or equivalent EHR platforms. - Experience with clearinghouse platforms such as Availity, Change Healthcare, or similar. - Exceptional written and verbal English communication skills. - High attention to detail with the ability to identify subtle discrepancies in coverage data. Requirements - CHAM, CHAA, or equivalent front-end revenue cycle certification (preferred). - Experience with automated eligibility verification tools and RPA solutions (preferred). - Background in denial root cause analysis related to eligibility and coverage errors (preferred). - Familiarity with AI tools and comfort evaluating AI-generated healthcare content (preferred). - Experience presenting eligibility performance data to senior leadership (preferred). Application Process - Upload resume - AI interview based on your resume - Submit form Resources & Support - For details about the interview process and platform information, please check: Interview Process - For any help or support, reach out to: support@mercor.com - Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.

Role Description Manage end-to-end prior authorisation workflows for medical and clinical services across multiple payer types. - Review clinical documentation to assess medical necessity against InterQual, MCG, or payer-specific criteria. - Evaluate AI-generated prior authorisation recommendations and clinical justification drafts for accuracy and appropriateness. - Coordinate with clinical staff, physicians, and payers to obtain timely authorisation approvals. - Track authorisation status, denials, and appeal outcomes to identify workflow improvement opportunities. - Annotate AI outputs and provide structured clinical feedback to support AI training datasets. Qualifications - Must-Have: - 5+ years of experience in prior authorisation, utilisation management, or clinical review, with at least 2 years in a management role. - Strong clinical background with knowledge of medical necessity criteria (InterQual, MCG, or equivalent). - Deep familiarity with commercial, Medicare Advantage, and Medicaid prior authorisation requirements. - Experience managing authorisation workflows across multiple specialities and service types. - Proficiency with authorisation management systems and EHR platforms (Epic, Cerner, or equivalent). - Exceptional written and verbal English communication skills. - High attention to detail with the ability to critically evaluate clinical documentation and AI-generated outputs. - Preferred: - Clinical licensure (RN, LPN, or equivalent) or relevant certification (CPUR, CPUM). - Experience with appeals and peer-to-peer review processes. - Familiarity with CMS prior authorisation rules and the No Surprises Act. - Background in physician office, hospital, or health plan prior authorisation operations. - Familiarity with AI tools and comfort evaluating AI-generated clinical content. Application Process - Upload resume - AI interview based on your resume - Submit form Resources & Support - For details about the interview process and platform information, please check: Interview Process - For any help or support, reach out to: support@mercor.com