Centivo Benefits Overview

Provides in-house legal counsel on healthcare regulations, contracts, privacy, ERISA, licensing, disputes, M&A, and due diligence. Negotiates client and vendor agreements, manages legal matters and outside counsel, oversees contract workflows in Ironclad, and develops automated legal processes. Advises on self-funded health plans, TPA operations, HIPAA, DOL requirements, medical licensing, and corporate practice of medicine issues.

Leads complex cross-functional Commercial initiatives from discovery through implementation, stabilization, and closeout. Responsibilities include project planning, business analysis, requirements gathering, process mapping, workflow improvement, UAT coordination, implementation readiness, documentation, training, and change enablement. The role partners with Sales, Client Success, Implementation, Marketing, Finance, Legal, Product, Operations, and Technology teams to improve commercial processes and scalability.

Leads Centivo’s Claims Management Ancillary Services and Plan Documents functions, overseeing strategy, compliance, quality, performance, workforce planning, and process improvement. Ensures accurate and timely SPDs, SMMs, SBCs, amendments, claims audits, appeals, recoveries, subrogation, and No Surprises Act processes. Manages two functional leaders, develops team performance, monitors operational KPIs, partners cross-functionally, and serves as the operational authority for clients, brokers, TPAs, and stop-loss carriers.