Anticipated End Date:

2024-12-24

Position Title:

Business Change Director-Claims/Payment Integrity Use-Case Lead

Job Description:

Business Change Director-Claims/Payment Integrity Use-Case Lead

Location: This position will work a hybrid model (remote and office). Ideal candidates must live within 50 miles of a PulsePoint location.

The Business Change Director-Claims/Payment Integrity Use-Case Lead is responsible for collaborating with business stakeholders and our IT department to ensure we are leveraging our clinical data (HealthOS) assets to drive downstream use cases for Payment Integrity. This role will ensure that we are correctly utilizing the data we receive, model out and monitor the value it is driving for the business stakeholder, and build a roadmap to continue to improve on the process. The Business Change Director is responsible for working with management to identify and implement varied projects, programs, and plans that support the achievement of business unit and enterprise goals.

How you will make an impact:

•   May specialize in one area of organization effectiveness (Claims/Payment Integrity) or be assigned to directly support a business unit and ensure activities are aligned with corporate strategy.
•   Identifies potential issues, project change, and scope data.
•   Leads efforts to identify best practices.
•   Identifies impacted parties, business partners, and resources required.
•   Develop and design processes and systems that support business needs.
•   Design methods for integrating functions and processes.
•   Conducts cost/benefit analyses.
•   Builds support for business change throughout the business unit. Provides process, project, and change management methodology coaching/consulting support to both local and enterprise-wide initiatives.
•   Leads the project prioritization and scheduling activities for the business unit.
•   Provides expertise to the business areas in culture/change management activities.
•   Provides expertise in process planning and portfolio management activities.
•   Supports the execution of the operating plan.

Minimum Requirements:

• Requires a BA/BS in a related field and minimum of 10 years managing mid to large-scale change/project initiatives; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

•   Risk Adjustment Data experience is strongly preferred.
•   Knowledge of planning models and methodology, project management, and change management experience (strategic and execution) strongly preferred.
•   Master’s degree preferred.
•   Six Sigma or PMP certification is a plus

For candidates working in person or remotely in the below location, the salary* range for this specific position is $121,176 to $181,764

Location: Denver, CO

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Job Level:

Director Equivalent

Workshift:

Job Family:

BSP > Business Support

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.