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Lead end-to-end product management for PBM, Ancillary Benefit Management, and specialty network offerings. Define roadmap, ensure regulatory and contractual compliance, drive profitability and client metrics, coordinate cross-functional stakeholders, streamline operations, support RFP/pricing, and launch/optimize products to align with business objectives.

Manage lower-level, non-complex workers' compensation claims: intake, coverage verification, compensability determination, reserve setting, authorize payments within limits, communicate status, follow client/carrier guidelines, and assist with complex claims under senior supervision.

Manage complex Workers' Compensation claims end-to-end: investigate compensability, establish reserves, authorize payments, coordinate with case managers and attorneys, handle subrogation and litigation, negotiate settlements, report to carriers, and maintain regulatory and client compliance while delivering strong customer service.

The Claims Assistant supports claims staff with the setup and administration of workers' compensation claims, processing mail, and assisting with calls.

Manage and grow assigned local/regional accounts, serving as the client-facing consultant. Drive revenue growth, manage collections, coordinate implementations, maintain stewardship reporting, lead renewal and upsell discussions, and document activity in Salesforce. Conduct regular client meetings, escalate issues, and ensure service delivery meets client expectations.

The Senior CERIS Operations Manager oversees departmental management including staff hiring, quality assurance, compliance with standards, and reporting metrics.

The Appeals Representative analyzes appeals in accordance with policies and guidelines, communicates with providers, and ensures timely completion of appeals while adhering to industry standards.

The Claims Supervisor oversees claims staff, ensuring compliance with laws, training, and performance evaluations, and assists with strategic projects.

The Indemnity Claims Specialist manages non-complex workers' compensation claims under supervision, ensuring compliance and effective communication with stakeholders.

The Data Verification Analyst validates data for the Bill Review system, performs clerical duties, and assists in communication regarding workload.