• Lead the operational strategy and execution of Medical Affairs activities with strong business acumen. • Ensure that strategy is translated into coordinated, high-impact execution across cross-functional stakeholders. • Partner closely across internal teams and external stakeholders to ensure compliant, efficient, and scalable solutions that support medical strategy, launch readiness, and scientific exchange. • Translate Medical Affairs strategy into aligned goals and cross-functional plans spanning scientific engagement, communications, evidence generation, and launch readiness. • Enable alignment between US and Global strategies and drive clarity on priorities and execution. • Serve as trusted advisor to Medical Affairs Leadership by synthesizing complex clinical, scientific, and market insights into actional recommendations.

• Lead and manage buy-side and sell-side accounting and financial due diligence engagements • Develop relationships with clients and engage in effective interactions with target company executives • Perform quality of earnings and working capital analyses • Identify and evaluate matters that potentially impact enterprise value and the purchase or sales price • Identify and evaluate financial and operational trends of target companies • Communicate effectively, both verbal and written, our due diligence findings • Supervise multiple professionals and prioritize tasks, serving as a hands-on lead for engagements from inception to completion • Participate in performance reviews and new business development activities

• Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit • Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities • Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services • Supports effective implementation of performance improvement initiatives for capitated providers • Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members • Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements • Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership • Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes • Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals • Participates in provider network development and new market expansion as appropriate • Assists in the development and implementation of physician education with respect to clinical issues and policies • Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components • Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care • Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality • Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment • Develops alliances with the provider community through the development and implementation of the medical management programs • As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues • Represents the business unit at appropriate state committees and other ad hoc committees • May be required to work weekends and holidays in support of business operations, as needed

• Provide clinical leadership and expertise to Medical Management staff, ensuring timely, consistent, and evidence-based responses to members and providers. • Lead utilization management and quality assurance activities, including oversight of medical necessity reviews and case management initiatives. • Support medical management programs through active participation in interdisciplinary clinical team activities and strategic decision-making. • Serve as the primary clinical and business liaison to network providers and healthcare facilities, fostering collaboration and supporting the effective implementation of medical services programs. • Conduct predetermination reviews and claim determination reviews, applying clinical judgment and expertise in medical coding, reimbursement, and coverage policies. • Provide guidance and consultation on complex clinical cases, helping ensure quality outcomes and regulatory compliance. • Support the development and continuous improvement of medical management strategies, policies, and processes.