NewLicensed Property & Casualty Insurance Agent - Remote USA TTECLicensed Property & Casualty Insurance Agent - Remote USAEagle Mountain, UTRemoteWebcam participation is expected during all instructor‑led TTEC and client‑required training, either throughout the session or at designated times, and is encouraged during coaching sessions to support meaningful connection and collaboration. Your training experience includes engaging, instructor‑led online sessions that use both webcam video and audio, so you can connect visually with trainers, leaders, and fellow teammates.
Mortgage Protection-Life Insurance Agent-Work from Home Symmetry Financial GroupMortgage Protection-Life Insurance Agent-Work from HomeSalt Lake City, UtahRemoteYou’ll have access to an exclusive CRM, a fully digital platform with up-to-date resources, and the ability to be contracted with multiple carriers, offering in-demand products like living benefits and more. This opportunity is perfect for career-driven professionals who want room to grow, sharpen leadership and business skills, and truly own their success.
Holistic Health Specialist - Work From Home Health Care Service CorpHolistic Health Specialist - Work From HomeSalt Lake City, UTRemote$61,500–$136,100 / yearFunctioning in a clinical care advisory role, assessing members for wellness education and disease management, introduces members to our website tools, educates members regarding wellness and specific conditions, and facilitates the coordination of care for identified members. Identifies alternate treatment programs; consults with physicians, providers, members, and other resources to evaluate options and services required to meet an individual's health needs.
Appointment Setter (Work From Home) American Income Life Insurance CompanyAppointment Setter (Work From Home)Salt Lake City, UTRemoteFull timeSince 1951, the company has focused on helping union members, association members, credit union members, and their families access life, accident, and supplemental health coverage options. Representatives work directly with clients to build long-term relationships and provide support in a comfortable, convenient setting.
Work From Home - Bilingual Client Services Representative AO Garcia AgencyWork From Home - Bilingual Client Services RepresentativeLehi, UtahRemoteAll interviews will be conducted via Zoom video conferencing (Global Elite Empire Consultants is a third-party recruiter, not an insurance agency) We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. Preferred Qualifications: • Bilingual (Spanish and English) • Excellent communication skills• Leadership capabilities • Self-starter • Positive attitude • Growth mindset .
Work From Home - Bilingual Client Services Representative Global Elite Empire ConsultantsWork From Home - Bilingual Client Services RepresentativeLehi, UtahRemoteWe may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. Preferred Qualifications: • Bilingual (Spanish and English) • Excellent communication skills • Leadership capabilities • Self-starter • Positive attitude • Growth mindset .
Licensed Insurance Sales Representative (Remote / Home-Based) Allstate Insurance CompanyLicensed Insurance Sales Representative (Remote / Home-Based)Salt Lake City, UTRemote$52,730–$76,480 / yearCustomer Centricity, Customer Insights, Customer Sales, Digital Literacy, Inclusive Leadership, Learning Agility, Results-Oriented, Sales, Sales Operations, Strategic Selling. Allstate's sales organization is growing its virtual workforce, and we are looking for highly motivated individuals that thrive in a fast-paced sales environment and enjoy being rewarded for their efforts.
Make an Impact on Others with a Career From Home Global Elite Empire ConsultantsMake an Impact on Others with a Career From HomeProvo, UtahRemoteWe may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. This is a remote opportunity where you’ll work directly with individuals who have requested help understanding their financial protection options.
Burned Out from the 9-5? There's Another Way - Remote Role Global Elite Empire ConsultantsBurned Out from the 9-5? There's Another Way - Remote RoleSouth Jordan, UtahRemoteAll interviews will be conducted via Zoom video conferencing (Global Elite Empire Consultants is a third-party recruiter, not an insurance agency) We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. Take advantage of this opportunity to work from home, enjoy a schedule that suits your lifestyle, and receive mentorship as you advance your career in client service leadership.
NewVirtual Life Insurance Agent - Remote InsuraTecVirtual Life Insurance Agent - RemoteSalt Lake City, UTRemoteLife Insurance Sales, Remote Sales, Final Expense, Mortgage Protection, Work from Home, Insurance Agent, Sales Closer, Entry Level Sales, Commission Sales, Licensed Insurance Agent, Virtual Sales, High Commission. We’re hiring Remote Life Insurance Agents who want to close high-quality leads, earn uncapped commission , and build a long-term career — all from home.
Burned Out from the 9-5? There's Another Way - Remote Role AO Garcia AgencyBurned Out from the 9-5? There's Another Way - Remote RoleSouth Jordan, UtahRemoteAll interviews will be conducted via Zoom video conferencing (Global Elite Empire Consultants is a third-party recruiter, not an insurance agency) We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. Incentives include but not limited to: • No cold calling • Qualified lead program • Advancement based on performance • Weekly pay • Mentorship and complete training • Industry leading tools and technology access • Work from home (web conference-based presentations) .
Insurance Sales Representative Symmetry Financial GroupInsurance Sales RepresentativeProvo, UtahRemoteWe are seeking individuals who are comfortable working independently, enjoy helping people, and are motivated by personal growth and income potential. Many of our agents come from backgrounds such as customer service, hospitality, healthcare, retail, or other people-focused industries.
Remote Insurance Sales Representative (Commission-Based) The Gainey AgencyRemote Insurance Sales Representative (Commission-Based)Salt Lake City, UTRemoteMust be legally authorized to work in the United States and able to meet applicable state licensing requirements. Opportunity to make a meaningful impact by helping families protect their financial future.
Remote Life and Health Insurance Agent GIA Legacy PlanningRemote Life and Health Insurance AgentCenterville, UtahRemoteIn this role, you’ll help individuals and families protect what matters most, all while developing high-value skills like communication, leadership, and business ownership. This is a career path designed for people who want flexibility, purpose, and real earning potential—not a one-size-fits-all job.
Remote Insurance Producer Joshua Monette Paz Farmers InsuranceRemote Insurance ProducerSalt Lake City, UTRemote$4,000–$13,000 / yearUpon successful completion of the 90-day probationary period, you MAY be invited to transition into a permanent Agency Producer role with expanded responsibilities and opportunities for advancement within the agency. During this time, you will receive targeted training, engage in client outreach, and develop core competencies in quoting, sales, and objection handling.
Entry Level Insurance Representative Symmetry Financial GroupEntry Level Insurance RepresentativeProvo, UtahRemoteThis opportunity is ideal for individuals looking for flexibility, income growth potential, and the ability to help families protect what matters most. • Connect with clients to discuss life insurance and financial protection needs.
Remote Life and Health Insurance Agent Symmetry Financial GroupRemote Life and Health Insurance AgentProvo, UtahRemoteIn this role, you’ll help individuals and families protect what matters most, all while developing high-value skills like communication, leadership, and business ownership. This is a career path designed for people who want flexibility, purpose, and real earning potential—not a one-size-fits-all job.
NewAccount Manager- Commercial Insurance - SBU Insurance Office of AmericaAccount Manager- Commercial Insurance - SBUDraper, UTRemote$59,000–$71,000 / yearFull timePlease note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity as there may be occasions when on-site presence is necessary to meet specific business needs. Coordinate day-to-day administrative and customer service activities, resolving complex issues, and ensuring no errors or omissions.
Licensed Insurance Agents | Non-Captive | Inhouse Leads MINK Life & Legacy AgencyLicensed Insurance Agents | Non-Captive | Inhouse LeadsSalt Lake City, UTRemote$3,000–$7,000If you're tired of long commutes or missing moments with family, this work-from-home opportunity offers a real path to a meaningful career — with free, proven training and full support. MINK Life & Legacy is seeking motivated, coachable individuals who want more time and more control.
Operations Technical Specialist (Commercial/Personal Insurance) Insurance Office of AmericaOperations Technical Specialist (Commercial/Personal Insurance)Salt Lake City, UTRemote$60,000–$85,000 / yearFull timePlease note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity as there may be occasions when on-site presence is necessary to meet specific business needs. Also administer EPIC, CSR24, Indio, and related tools including adding new users, user terminations, resolving user issues.
Operations Supervisor- Commercial Insurance (Remote) Insurance Office of AmericaOperations Supervisor- Commercial Insurance (Remote)Alpine, UTRemote$105,000–$125,000 / yearFull timePlease note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity as there may be occasions when on-site presence is necessary to meet specific business needs. This includes guiding team performance, ensuring compliance with established processes and procedures, maintaining service excellence, supporting staff development, and strengthening operational efficiency.
Remote Mortgage Protection Insurance Agent MINK Life & Legacy AgencyRemote Mortgage Protection Insurance AgentProvo, UTRemote$150,000–$200,000If you're tired of long commutes or missing moments with family, this work-from-home opportunity offers a real path to a meaningful career — with free, proven training and full support. Mink Life & Legacy is seeking motivated, coachable individuals who want more time and more control.
Remote Insurance Sales Agent – No Experience Needed MINK Life & Legacy AgencyRemote Insurance Sales Agent – No Experience NeededSalt Lake City, UTRemote$150,000–$200,000If you're tired of long commutes or missing moments with family, this work-from-home opportunity offers a real path to a meaningful career — with free, proven training and full support. Mink Life & Legacy is seeking motivated, coachable individuals who want more time and more control.
NewCustomer Service Associate Fiserv IncCustomer Service AssociateUTRemote$31,200–$46,800 / yearThis is a remote role and you must reside in one of the following states; Florida, Wisconsin, Idaho, Georgia, Mississippi, Hawaii, Indiana, Iowa, Kansas, South Carolina, Louisiana, West Virginia, Michigan, Wyoming, Nebraska, North Carolina, Oklahoma, Texas, Utah, Virginia and Arizona. About your role: As a Remote Customer Service Associate, you will support bank partners, merchants, and cardholders by answering questions and resolving issues related to electronic payments and financial services.
Bilingual Spanish Inbound Customer Service Agent - Consumer Relations (Remote) Haier US Appliance Solutions IncBilingual Spanish Inbound Customer Service Agent - Consumer Relations (Remote)Salt Lake City, UTRemoteAfter 10 weeks of training, you will utilize multiple Windows-based programs and other internal applications to: Take ownership in resolving escalated customer concerns, including capturing all the facts surrounding complaints, following the outlined steps to resolve issues, data management, and responding to all letters of inquiry. USA, Rapid City, SDUSA, Austin, TX, USA, Columbia, SC, USA, Columbus, OH, USA, Jackson, MS, USA, Louisville, KY, USA, Nashville, TN, USA, Oklahoma City, OK, USA, Salt Lake City, UT, USA, Sioux Falls, SD.
Inbound Customer Service Agent - Consumer Relations (Remote) Haier US Appliance Solutions IncInbound Customer Service Agent - Consumer Relations (Remote)Salt Lake City, UTRemoteAfter 10 weeks of training, you will utilize multiple Windows-based programs and other internal applications to: Take ownership in resolving escalated customer concerns, including capturing all the facts surrounding complaints, following the outlined steps to resolve issues, data management, and responding to all letters of inquiry. USA, Rapid City, SDUSA, Austin, TX, USA, Columbia, SC, USA, Columbus, OH, USA, Jackson, MS, USA, Louisville, KY, USA, Nashville, TN, USA, Oklahoma City, OK, USA, Salt Lake City, UT, USA, Sioux Falls, SD.
Inbound Customer Service Agent – Consumer Relations (Remote) GE Appliances, a Haier companyInbound Customer Service Agent – Consumer Relations (Remote)Salt Lake City, UTRemoteAfter 10 weeks of training, you will utilize multiple Windows-based programs and other internal applications to: + Take ownership in resolving escalated customer concerns, including capturing all the facts surrounding complaints, following the outlined steps to resolve issues, data management, and responding to all letters of inquiry. . USA, Rapid City, SDUSA, Austin, TX, USA, Columbia, SC, USA, Columbus, OH, USA, Jackson, MS, USA, Louisville, KY, USA, Nashville, TN, USA, Oklahoma City, OK, USA, Salt Lake City, UT, USA, Sioux Falls, SD.
Bilingual Spanish Inbound Customer Service Agent - Consumer Relations (Remote) GE Appliances, a Haier companyBilingual Spanish Inbound Customer Service Agent - Consumer Relations (Remote)Salt Lake City, UTRemoteAfter 10 weeks of training, you will utilize multiple Windows-based programs and other internal applications to: Take ownership in resolving escalated customer concerns, including capturing all the facts surrounding complaints, following the outlined steps to resolve issues, data management, and responding to all letters of inquiry. . USA, Rapid City, SDUSA, Austin, TX, USA, Columbia, SC, USA, Columbus, OH, USA, Jackson, MS, USA, Louisville, KY, USA, Nashville, TN, USA, Oklahoma City, OK, USA, Salt Lake City, UT, USA, Sioux Falls, SD.
Remote Inbound Customer Service Agent - 8.17 Start Grand Circle LLCRemote Inbound Customer Service Agent - 8.17 StartUTRemoteIn addition to base pay, this role is eligible for an annual incentive bonus and first-class benefits, which include: Health & wellness: Comprehensive and heavily subsidized medical, dental, and vision plans, plus on-site gym access, holistic wellness sessions, and group fitness classes. As a Traveler Advisor you will be responsible for taking inbound calls from GCCs confirmed Travelers, assisting them with maintaining their itinerary through various functions.
NewSales Manager - Remote InsuraTecSales Manager - RemoteSalt Lake City, UTRemoteAbout InsuraTec Services Group: At InsuraTec Services Group, we're redefining insurance sales with a customer-centric approach. As a Sales Manager, you'll be pivotal in connecting clients with the insurance coverage they require, all while enjoying the perks of remote work with flexible hours.
Remote Customer Service Representative SweetepictravelsRemote Customer Service RepresentativeSalt Lake City, UtahRemoteJoin our dynamic team as a Remote Customer Service Representative, where your enthusiasm and dedication will elevate client interactions and foster lasting relationships. Your proactive approach will help streamline communication, enhance customer satisfaction, and support the overall success of our client engagement strategies.
NewMember Service Representative Shared Service Solutions LLCMember Service RepresentativeUTRemoteTOP JOB RESPONSIBILITIES: Answer high-volume inbound calls and use strong technical proficiency to navigate multiple systems (telephony platform, account servicing tools, CRM, knowledge base, and web-based applications) to provide accurate information, resolve inquiries, and fulfill requests for member and non-member callers. Problem solving and critical thinking; Exercise good judgement/reasoning and resourcefully solve routine problems; Organize and handle multiple tasks and prioritize; Handle confidential/sensitive information; Exhibit excellent customer service skills.
Temporary Customer Service Professional I Cambia Health Solutions IncTemporary Customer Service Professional IUTRemote$19–$22.25 / hour6 months of customer service call center experience; or 6 months of customer service experience in insurance, retail, banking, hospital, medical office or similar industry with extensive customer contact; or equivalent combination of education and experience. As the face of Cambia, our CSPs play multiple roles - listener, problem-solver, investigator and advocate - all in service of making our members' health journeys easier and days brighter.
Sales Representative, Inbound Remote Liberty Mutual Holding Company IncSales Representative, Inbound RemoteUTRemote$55,000–$75,000 / yearJob Details: As an Inside Sales Agent you will be handling inbound calls and warm leads, consulting with customers on their insurance needs and match the correct coverages, products, and benefits to convert sales leads into policyholders. Bring your unique sales talent to our Fortune 100 company and receive paid-training, licensing in all 50 states, and a dynamic role that directs only warm leads your way (no cold calls) - because we believe in supporting your success, not holding it back.
RCM Client Services Associate AdvancedMDRCM Client Services AssociateSouth Jordan, UtahRemoteAdvancedMD is a unified cloud suite of medical office software hosted on Amazon Web Services/AWS including practice management, electronic health records, and patient engagement, and offers managed medical billing services for independent practices. In this dynamic role, you’ll combine technical support expertise, medical billing knowledge, and strong communication skills to resolve client inquiries, guide them through software functionality, and ensure smooth billing operations.
Remote Inside Sales Representative Liberty Mutual Holding Company IncRemote Inside Sales RepresentativeProvo, UTRemote$55,000–$75,000 / yearBring your unique sales talent to our Fortune 100 company and receive paid-training, licensing in all 50 states, and a dynamic role that directs only warm leads your way (no cold calls) - because we believe in supporting your success, not holding it back. As an Inside Sales Agent you will be handling inbound calls and warm leads, consulting with customers on their insurance needs and match the correct coverages, products, and benefits to convert sales leads into policyholders.
NewNon-Clinical Care Coach Humana IncNon-Clinical Care CoachUTRemote$53,700–$72,600 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Minimum 2 years of experience in any direct adult patient care such as, but not limited to: long-term care, home and community-based services, hospital/facility setting, case management, managed care organizations.
Senior Informaticist Humana IncSenior InformaticistUTRemote$97,900–$133,500 / yearWork at Home Requirements To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients.
Entry-Level Remote Customer Associate AILEntry-Level Remote Customer AssociateSalt Lake City, UTRemoteFull timeWe’re seeking motivated individuals with: A self-driven mindset and strong organizational skills to prioritize and multitask effectively. Here’s what you can expect: Earning Potential: Annual compensation of up to $300,000+ through renewals and a highly competitive bonus structure.
Remote Bilingual Monitoring Representative ADT IncRemote Bilingual Monitoring RepresentativeSalt Lake City, UTRemoteNow hiring in the following states: Alabama, Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming. We will rely on you to listen to our customers and use your deductive reasoning skills, technical expertise, creativity and passion for helping to meet their needs - and remind them that behind our great products is a focus on the customer experience with accountable and collaborative team members ready to help them.
NewHR Solutions Partner HumanaHR Solutions PartnerSalt Lake City, UTRemote$65,000–$88,600 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The HR Solutions Partner 2 provides expertise through HR consulting and coaching including working with business leaders to solve significant people issues, provides expertise in technical and regulatory aspects of employment including hiring, contingent labor including, policy, process & practices, administration, performance management, workforce reductions, etc.
NewRemote Customer Technical Support ADT IncRemote Customer Technical SupportSalt Lake City, UTRemoteThe Customer Technical Support Team is responsible for all residential and small business inbound phone calls, which consists of assisting customers with alarm system questions, finding solutions for technical issues, walking the customer through troubleshooting steps, and other technical assistance. Troubleshoot the customer's technical issues by using our guided workflows which walk you and the customer step by step through various resolutions with the goal of solving the customers issue while on the phone.
NewTravel Advisor Christopherson Business TravelTravel AdvisorSalt Lake City, UTRemoteFull timeTechnology Proficiency: Proficient in the Microsoft Office Suite (Outlook, Word, Excel, Teams, PowerPoint) and comfortable working with Google Workspace (Docs, Sheets, Gmail); experience with CRM or support platforms (e.g., Salesforce, Zendesk) a plus. Customer Centricity: Makes things easy for the customer; is helpful and adds value; personalizes the experience; maintains accuracy; treats customers professionally; sets expectations and follows through.
Pharmacy Services Technician Cambia Health Solutions IncPharmacy Services TechnicianUTRemote$20.50–$30.80 / hourAssist with auditing and investigations of medication-related claims, cases, and providers to identify misuse of medications, misuse of resources, substance abuse, and erroneous and fraudulent billing practices; investigate and organize workflow for claims referred to Pharmacy Services for review and allowable determination including miscellaneous J codes, providers on review, and reconsiderations. Support wellness and disease state management programs for Pharmacy Service and corporately which contribute to NCQA accreditation and ongoing quality improvement; contribute to and support the corporation's quality initiatives through process improvement teams and by encouraging team and individual contributions toward quality improvement efforts.
Bilingual Interpreter (English <> Haitian Creole) TransPerfect IncBilingual Interpreter (English <> Haitian Creole)UTRemoteTransPerfect Connect (TPC) is the world's leading provider of remote interpreting solutions, including over-the-phone interpretation (OPI), video remote interpretation, multilingual email and chat support, business process outsourcing, and global call center services. Interpreters manage continuous live calls, often under pressure, while strictly following interpretation protocols to maintain neutrality, accuracy, and confidentiality.
Remote Customer Service Representative (WFH) Globe Life AIL - Lisa RusselRemote Customer Service Representative (WFH)Salt Lake City, UTRemoteFull timeAs part of Globe Life, our organization has continued to experience strong year-over-year growth—even during challenging economic conditions—demonstrating both our stability and the essential nature of the services we provide. For over 70 years, we have proudly served working-class families by providing life, accident, and supplemental health benefits to members of labor unions, credit unions, associations, and their families.
DSO Dental Billing Success Consultant eAssistDSO Dental Billing Success ConsultantAmerican Fork, UTRemoteFull timeAt eAssist Dental Solutions, we empower dental practices by providing expert-driven, AI-powered dental billing solutions that maximize collections, streamline revenue cycle management, and allow dental teams to focus on patient care. eAssist currently serves over 3000 dental practices through a unique proprietary technology platform that connects dental practices to vetted dental billing professionals, allowing practice owners to fully outsource their billing department.
Licensed Medicare Benefit Advisor- Remote Allstate Insurance CompanyLicensed Medicare Benefit Advisor- RemoteUTRemote$55,000–$100,000 / yearAs a Medicare Benefit Advisor, you'll utilize your in-depth Medicare knowledge and sales skills to consult retired seniors on the most beneficial Medicare Life and Health Plans that best suit their specific needs. Essential Duties as a full-time Medicare Benefit Advisor: Consult and educate seniors 65 years of age and older on the best Medicare Life and Health Plans that would best suit their needs.
Remote Customer Support Team Lead SweetepictravelsRemote Customer Support Team LeadSalt Lake City, UtahRemoteJoin our dynamic team as a Remote Customer Support Team Lead, where your enthusiasm and dedication will elevate client interactions and foster lasting relationships. Your proactive approach will help streamline communication, enhance customer satisfaction, and support the overall success of our client engagement strategies.
Remote Care Management Nurse Cambia Health Solutions IncRemote Care Management NurseSalt Lake City, UTRemote$36.80–$49.80 / hourAs a member of the Clinical Services team, our Care Management RN's provide clinical care management (such as case management, disease management, and/or care coordination) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes. Collaborates with physician advisors, internal and external customers, and other departments to resolve claims, quality of care, member or provider issues, and identifies problems or needed changes, recommending resolutions and participating in quality improvement efforts.