Risk

• Conducts virtual risk control and self-surveys to determine potential hazards and risk factors relating to underwriting/risk selection
• Writes technically detailed reports that provide a clear assessment of risk and clearly articulates recommendations
• Consults with clients on ways to control hazards to reduce or prevent losses
• Influences clients to implement recommendations
• Explains how their recommendations or department value-added programs can help minimize risks
• Provides technical advice/assistance and account information to underwriting business partners, insureds, and other customers for analysis and to ensure superior customer service
• Uses automated workflows to review responses to recommendations submitted by insureds and agents
• Refers incomplete recommendations to underwriting team members
• Recognizes opportunities to provide risk control products and services that can help reduce losses
• Plans and schedules risk control evaluations with insureds and researches risks via internal and external resources in order to complete evaluations

Virtual Risk Control Representative

• Drive analytical strategies and solutions to optimize Medicare Risk Adjustment (RA) performance
• Deliver actionable insights and build dynamic visualizations
• Provide strategic advisory services to internal stakeholders and senior leadership
• Analyze revenue optimization, risk forecasts, HCC coding logic, RADV audits, Medicare segmentation, and data & logic governance
• Build interactive visualizations and interpret CMS model updates

Principal Risk Adjustment Analytics Consultant

• Oversee day-to-day operations and strategic execution of enterprise risk adjustment programs
• Assist management overseeing risk adjustment programs including claims, vendor quality, and audits
• Develop metrics, policies, and procedures for validation of programs return on investment
• Collaborate with operations risk and compliance teams for implementing initiatives
• Provide oversight and ensures accurate coding for Medical Revenue Management programs
• Serve as a subject matter expert on coding
• Work collaboratively with Enterprise Risk Adjustment team, Business Operations, Regulatory Compliance, and Internal Audit
• Influence others and work effectively to develop relationships with stakeholders

Risk Adjustment Strategic Manager

• Support the development of affordability strategic initiatives aligned with CHC and enterprise goals and market needs
• Conduct robust internal reviews and external market scans to identify emerging trends, capability gaps, and innovation opportunities
• Enable effective governance execution through end-to-end coordination of meeting logistics, documentation of key decisions and actions, and structured stakeholder follow-up to maintain momentum and accountability across initiatives
• Collaborate with matrix partners across CHC clinical teams, along with other internal teams including clinical, product, data and analytics, and operations to ensure strategic alignment
• Participate in cross-functional workgroups as a proxy for CHC affordability and payment integrity strategy, contributing to the design of new commercial programs and products
• Analyze claims and operational data to identify trends, gaps, and affordability opportunities
• Translate complex data into clear, actionable insights for both payment strategy and non-payment stakeholders
• Proficiency in using data visualization and analytics tools (e.g., Excel, Tableau) to develop dashboards, reports, and presentations that inform strategic decisions
• Prepare executive-level presentations, memos, and updates on strategic affordability initiatives and projects

Affordability Strategy and Governance Lead

• Own and evolve the IT Governance framework for digital platforms focusing on control standards, and operational enforcement.
• Design and implement technical governance controls embedded in SDLC and platform delivery workflows.
• Actively monitor governance effectiveness using leading indicators and control health metrics, providing valuable insights for continuous improvement.
• Design and maintain proactive KPI dashboards that provide visibility into: Technology governance adherence, Access, auditability, and traceability controls, Third‑party and vendor digital risk posture.
• Support Quality‑led audits and inspections through: System‑generated evidence and dashboards, Traceability from governance design to execution, Coordinated, technology‑focused responses to findings.
• Define data governance frameworks aligned with enterprise guidelines. Own the IT execution of data governance, including: Metadata, lineage, and traceability standards in Alation, Data access, classification, and lifecycle controls.
• Ensure governance controls are implemented and monitored through platforms Ensure digital platforms support ALCOA+ principles by design (audit trails, access controls, traceability). Surface data integrity risks via digital risk dashboards and defined escalation paths. Partner with Data & Analytics teams to operationalize governance through: Data catalogs, Stewardship models, Data quality monitoring. Serve as escalation point for data integrity risks impacting clinical, operational, or regulatory outcomes.
• Establish and operationalize an AI Governance framework aligned with enterprise responsible AI framework. Ensure AI governance adherence is measurable, continuously monitored, and enforceable. Embed governance into AI lifecycle processes (design, development, deployment, monitoring) in partnership with Architecture, Development, Security, and Quality teams. Govern both vendor provided and internally developed AI capabilities.
• Lead IT Governance, Data Governance, and AI Governance councils, ensuring consistent decision making across digital domains.
• Support IT inspection readiness, including: Evidence preparation and traceability, Governance documentation and KPI dashboards, Coordinated IT responses during regulatory and sponsor inspections. Partner with Quality on CAPA remediation related to: IT systems, Data integrity, Technology enabled processes.

Director, Digital Governance

• Develop and execute a comprehensive safety and risk management strategy for all corporate and franchise operations
• Establish safety standards, policies, procedures, and best practices that support operational excellence and risk reduction
• Create and manage company-wide safety scorecards, KPIs, dashboards, and reporting systems
• Lead initiatives designed to reduce workplace injuries, vehicle accidents, cargo claims, and insurance losses
• Foster a culture of accountability, leadership, and safety ownership across all levels of the organization
• Provide executive leadership with regular reporting and recommendations regarding safety trends, risks, and corrective actions
• Serve as the organization's primary authority on regulatory compliance and monitor regulatory changes
• Oversee the company's captive insurance programs and risk management initiatives
• Analyze workers' compensation, auto liability, general liability and cargo claims and implement proactive loss prevention strategies
• Develop and deliver safety certification programs for franchise owners and operational leaders
• Build and lead a high-performing safety and risk management function

Director of Safety and Risk Management

• Drive revenue integrity and analytics strategy by consulting on strategic initiatives
• Lead cross-functional teams and collaborate with risk adjustment analysts
• Transform complex financial and risk adjustment data into actionable business intelligence
• Champion advanced data science initiatives by developing predictive models
• Deliver strategic, data-driven insights and collaborate with stakeholders on revenue accuracy

Manager, Medicare Risk Adjustment Analytics Consulting

• Provide enterprise leadership to design, standardize, and improve the end to end operating model across HEDIS and Risk Adjustment
• Drive improvements in data collection, processing, encounter creation and management, submission controls, reconciliation, and audit readiness
• Ensure execution across internal teams, technology partners, analytics, finance, and external vendors is aligned and coordinated
• Establish and maintain governance structures for regulatory compliance, audit readiness, and defensible outcomes
• Own the end to end vendor operating model for Risk Adjustment
• Serve as the primary integrator across Quality, Performance Outcomes, Technology, Data, Analytics, Finance, Actuarial, Provider Quality, and external partners

Senior Director, Risk Adjustment

• Directly manage and develop a team of analysts performing EDD reviews of varying complexity; set performance expectations, provide coaching, and complete performance feedback processes
• Own daily operations and workload planning (intake, assignment, prioritization, and capacity planning) to ensure reviews are completed within SLA timeframes
• Establish and monitor team performance metrics (timeliness, productivity, quality) and drive corrective actions where needed
• Oversee case assignment and case status management; remove blockers and coordinate rework for quality issues
• Lead a quality control and sampling program for completed EDD reviews; identify root causes, document findings, and implement training and process improvements
• Maintain and refine team procedures, process flows, templates, and job aids; ensure changes are communicated and adopted consistently
• Partner with first-line business units and internal stakeholders to obtain required customer information and documentation; ensure requests are clear, appropriately risk-based, and timely
• Manage escalations of financial crime red flags and unusual activity; ensure appropriate risk decisions, documentation, and handoffs (e.g., SAR investigation referral) occur in accordance with policy
• Support leadership in maturing the EDD/HRC program by recommending process enhancements, tooling opportunities, and risk-based approaches that improve defensibility and efficiency
• Provide reporting and analysis on pipeline health, trends, and recurring issues to management; escalate emerging risks and capacity concerns
• Coordinate audit, compliance testing, and exam support for the team, including evidence gathering, response drafting, and remediation of findings
• Lead and/or support ad hoc projects and initiatives as assigned.

Manager, BSA – High Risk Customer Reviews

• Lead the application of actuarial and quantitative methods to the underwriting of credit insurance transactions.
• Translate traditional insurance frameworks (reserving, NAIC capital considerations, risk-based capital) into structured credit underwriting practices.
• Lead the creation and enhancement of complex quantitative models for credit risk and in-market products.
• Evaluate insurance company balance sheets, reserving practices, and capital adequacy in counterparty assessments.
• Compile and process historical data, perform sophisticated data analysis using AI/ML tools, build and refine models using regression analysis and ML tools, and oversee implementation and production.
• Develop and refine internal risk frameworks, actuarial methodologies, and reserving protocols for credit insurance.
• Drive research initiatives to explore new modeling methodologies and techniques, staying abreast of industry advancements.
• Collaborate with underwriters, senior management, and insurance partners to ensure alignment of actuarial standards with credit risk methodologies.
• Lead ad-hoc analytics projects to address specific business needs and challenges.

Quantitative Risk Modeling Lead

• Provide risk support to the MPS North America revenue organization
• Build strong relationships with respective teams, including leadership
• Ensure compliance with laws, rules, and regulations
• Ensure assigned areas have an adequate control framework in place
• Train different levels and new staff as assigned
• Interact directly with senior managers requiring advanced presentation, relationship building and negotiation skills
• Occasionally expose to regulatory agencies

Merchant Payment Services Risk Advisory

• Must be able to complete an entire report, cover to cover, to a “client ready” standard
• Originate select work, partnering with leadership to identify targets
• Spend majority of time completing assignments, with approximately 20-50% of time spent on coaching analysts, senior analysts, and associates
• Personally inspect most assignments and assist other team members on inspections (within reason)
• Attend at least one local commercial real estate event per year, not counting classes

Director – Value and Risk Advisory

• Monitor PMO processes, procedures, and outputs for compliance with quality and governance standards, escalating deviations or concerns as identified
• Collect, analyze, and report data related to quality and compliance performance
• Support the design, refinement, and implementation of quality assurance protocols and governance frameworks through documentation and testing activities
• Identify process gaps, inconsistencies, or risks and support corrective actions
• Assist with internal and external audit preparation and follow-up activities
• Identify opportunities to apply automation or AI-assisted analysis to support monitoring and reporting, consistent with established governance standards

PMO Quality and Governance Coordinator

• Learn to perform duties in Risk Management under general supervision.
• Support risk management activities related to risk assessments and practices.
• Conduct non-financial risk assessments and risk reviews.
• Support GRC software activities.
• Synthesize data into actionable insights from large amounts of data across multiple systems.
• Collaborate frequently with other areas of the credit union.

Risk Management Intern

• Conduct risk assessments, site surveys, and deliver actionable recommendations to reduce loss exposure with focus on customer-centricity and our service model to form partnerships while mitigating risk.
• Collaborate with underwriting, claims, and customers to develop tailored risk improvement strategies. Working with our distribution partners to help differentiate The Hartford in the marketplace.
• Leverage data analytics and digital tools to provide insights and predictive solutions.
• Serve as a trusted advisor, educating clients on emerging risks and best practices.
• Contribute to innovation initiatives that integrate AI and human expertise for precision and speed.

Risk Engineer – All Levels, Specialty Areas

• Leads business case development for proposed initiatives
• Supports the strategic planning process
• Ensures that initiatives support the strategic business plan
• Provides strategic and policy guidance on assigned initiatives
• Organizes work teams and drives consensus
• Performs detailed analysis of data, workflows, policies, and procedures
• Writes and delivers communication to all levels of organization

Payment Integrity Specialist – Governance

• Creates strategy influencing business methods and integrated security restrictions, weighing complex requirements from the business with industry best practices for security
• Develops an enterprise strategy for Cyber Security while ensuring scalability and automation across lifecycle - will include strategies for role-based access control and lifecycle management
• Takes overall responsibility for architecture, planning and delivery of enterprise-level Cyber Security programs
• Works across teams to document and share Cyber Security best practices for on premise and cloud-based solutions for employees, contractors, and vendors
• Leads the use of Cyber Security tools (people, process, technology) for the optimization of SOX compliance efforts
• Ensures overall IT strategy and architecture plans and standards are translated into Cyber Security service programs, methods, and technologies as they align with leading Cyber Security practices
• Leads application development Cyber Security strategy for both internal service to service as well as end consumer to application authentication and authorization using modern techniques
• Manages, coaches, leads, and develops a staff of Cyber Security personnel
• Partners with other business functions on all aspects of Cyber Security strategy and requirements
• Thinks analytically, and able to understand and report metrics that matter (quantifiable and actionable) then translates into slides executive level audiences with limited technical knowledge can understand
• Develops and retains a high performing team – drive deep technical ability across the entire Cyber Security team
• Prioritizes and meets deadlines, goals, and objectives

Cyber Governance and Resilience Manager

• Build and maintain matching, concordance, and survivorship processes
• Develop data quality rules, monitoring, and dashboards
• Perform SQL analysis and Python-based automation/validation
• Manage data issues, track resolution, and support governance workflows
• Partner with engineering teams (e.g., Databricks) and business stakeholders
• Maintain governance documentation, standards, and metrics
• Support CRM data standards and validation processes

Data Governance, MDM Specialist

• Responsible for vetting out the contractor's qualifications
• Review contractor background checks for risk factors
• Validate contractor’s license, insurance, OFAC status, SOS, and other qualifying information
• Use AI tools to research the contractor thoroughly to provide a risk score and recommendation
• Responsible for completing a collateral/project review
• Review construction-related documents for GSE program acceptance
• Research and review local jurisdiction/permitting requirements
• Evaluate construction contracts for industry best practices
• Review plans and specifications for accuracy
• Review plot plans/surveys for accuracy
• Review inspection/warranty requirements
• Review foundation/final survey requirements
• Analyze construction budgets and draw schedules for risk
• Review appraisal reports against project documents, such as the plans and specifications, and the budget.
• Use AI tools to assist with completing the project review

Construction Risk Analyst

• Provide value added loss prevention services to our Business Insurance accounts
• Establish and maintain valued risk management relationships with our clients
• Evaluate employee safety exposures and controls and providing effective risk improvement solutions
• Effectively promote our risk control capabilities in new business opportunities
• Assess Automobile/fleet, General Liability and Crime exposures with effective feedback on exposures and controls in place and/or needed
• Develop insightful risk assessment reports for external and internal customers
• Serve as a liaison for loss control activities between client and carrier
• Monitor loss information and analyze trend development; develop effective overview and solutions
• Provide effective loss control resources and solutions to clients
• Develop and maintain proactive service plans established with client’s support and buy-in
• Develop and conduct effective safety training programs using PowerPoint with multi-media
• Conduct Commercial and Industrial Property fire/safety inspections and effectively relating proper risk control measures (NFPA codes)

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