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Elevance Health jobs

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SOLUTIONS MANAGEMENT MANAGER

Oversees the daily activities supporting tactical execution of growth initiatives and management of long-term strategic growth initiatives including continuous improvement, new capability development, and innovative technologies...

CompanyElevance Health
AddressSOUTH PORTLAND, ME
CategoryInformation Technology
Date Posted 7 days ago See detail

Solutions Management Manager

Elevance Health

SOUTH PORTLAND, ME

Oversees the daily activities supporting tactical execution of growth initiatives and management of long-term strategic growth initiatives including continuous improvement, new capability development, and innovative technologies...

7 days ago seen See more...

Manager Pharmacy Clinical Operations - CarelonRx - Mail-Order Call Center

Elevance Health

GRAND PRAIRIE, TX

Assists in the development of new clinical products. Oversees the Prior Authorization Center. Implements new prior authorization program. Manages clinical pharmacy operations and staff to ensure clients' objectives and deliverable...

7 days ago seen See more...

Customer Care Representative I

Elevance Health

Henderson, NV

Responds to internal and external customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. . Analyzes problems and provides information/solutions. Opera...

7 days ago seen See more...

Network Data Specialist I

Elevance Health

Miami, FL

Assists in synchronization of data among multiple claims systems and application of business rules as they apply to each database. . Validates the data to be housed on provider databases and ensuring adherence to business and sy...

7 days ago seen See more...

Outreach Care Specialist

Elevance Health

New Hampshire, United States

Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs. Assesses member compliance with medical treatment plans via telephone or through on-site visits. Identifies barriers t...

7 days ago seen See more...

Sales Account Rep II

Elevance Health

INDIANAPOLIS, IN

Advises clients on developing and designing specific benefit plans that will best suit the client's needs. Directs and coordinates benefit design issues and modifications with Operations and Membership Implementation staff in sup...

7 days ago seen See more...

Security Analyst Senior - Integration Management

Elevance Health

NORFOLK, VA

Lead strategic discussions to facilitate planning of integration activities, identify and remediate risks and issues, drive decisions, and track integration activity progress. . Facilitate cross-functional discussions to address...

7 days ago seen See more...

Business Change Director

Elevance Health

WOODLAND HILLS, CA

May specialize in one area of organization effectiveness (planning, project portfolio, or culture/change) or be assigned to directly support a business unit and ensures activities are aligned with corporate strategy. . Identifies...

7 days ago seen See more...

Community Health Care Case Worker

Elevance Health

Las Vegas, NV

Responds to telephone, written, and in-person inquiries and initiates steps to assist regarding issues relating to content or interpretation of benefits, policies and procedures. Provides timely and accurate resolution of inquirie...

a week ago seen See more...

Nurse Practitioner – Virtual 24/7 Nurse Line

Elevance Health

Phoenix, AZ

Responsible for reviewing clinical assessments gathered by triage RN and helping develop a plan of care for patients concern. . Provides clinical support to triage RNs as clinical questions or concerns arise. . Will assess and t...

a week ago seen See more...

Behavioral Heath Care Manager II

Elevance Health

WOBURN, MA

Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guideline...

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Patient Transportation Lead

Elevance Health

SAN JUAN, PR

Works daily reports of services coordinated and performed in the Department. Identifies situations in the Route Coordination Department, reassigning and organizing staff according to operational needs in the Call Center and Coordi...

a week ago seen See more...

Claims Rep I

Elevance Health

MERIDIAN, ID

Learning the activities/tasks associated with his/her role. Works under direct supervision. Relies on others for instruction, guidance, and direction. Work is reviewed for technical accuracy and soundness. Codes and processes cla...

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BH Case Manager II

Elevance Health

Atlanta, GA

Responds to more complex cases and account specific requests. Uses appropriate screening criteria knowledge and clinical judgment to assess member needs. Conducts assessments to identify individual needs and develops specific ca...

a week ago seen See more...

RVP Sr Clinical Officer-Commercial CA.

Elevance Health

SAN FRANCISCO, CA

Partnering closely with other leaders to manage the organization's growth, profit & loss (P&L) margin, vendor oversight, stakeholder management, and provider relationships. Sets and executes priorities to improve health care cost...

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Referral Specialist I (US)-7

Elevance Health

INDIANAPOLIS, IN

Initiates and manages clinical referrals for pre-authorization. Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources. Reviews referrals for completeness and follows up for addi...

a week ago seen See more...

Business Information Developer Consultant Senior

Elevance Health

NORFOLK, VA

Undertakes complex assignments requiring additional specialized technical knowledge. . Develops very complex and varied strategic report applications from a data warehouse. . Establishes and communicates common goal and direction...

a week ago seen See more...

Nurse Medical Management II

Elevance Health

PALO ALTO, CA

Conducts precertification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, be...

a week ago seen See more...

Associate General Counsel

Elevance Health

LOUISVILLE, KY

Routinely works on complex problems in which analysis of situations and/or facts require an in-depth evaluation of various factors; or large scale enterprise initiatives with broad organizational impact. . Provide legal guidance...

a week ago seen See more...

Innovation Director & Chief of Staff, Corporate Enterprise - Legal/Digital

Elevance Health

Boston, MA

Collaborate with the Digital and Corporate Enterprise Legal leadership teams to develop, communicate, and execute the teams strategic goals, ensuring alignment with overall enterprise objectives. Lead and manage innovation initia...

a week ago seen See more...

Provider Contract/Cost-of-Care Consultant

Elevance Health

CHICAGO, IL

Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on co...

a week ago seen See more...

Investigator II

Elevance Health

NORFOLK, VA

Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims. . Responsible for identifying and...

a week ago seen See more...

Referral Specialist I (US)-9

Elevance Health

INDIANAPOLIS, IN

Initiates and manages clinical referrals for pre-authorization. Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources. Reviews referrals for completeness and follows up for addi...

a week ago seen See more...

Specialty Sales Dir - Specialty Sales

Elevance Health

NORFOLK, VA

Focuses on strengthening key relationships, while driving sales and retention results. . Works in partnership with local medical leadership and teams to ensure field sales and retention team goals are met. . Fosters both interna...

a week ago seen See more...

Clinical Review Nurse I (US)

Elevance Health

Waukesha, WI

Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials. . Requires AS in nursing and minimum of 1 year of clinical experience; or any combination of...

a week ago seen See more...

Behavioral Health Case Mgr II - West Virginia

Elevance Health

Charleston, WV

Completes face-to-face visits with the member in the home, hospital, and other community settings, such as doctor's offices, treatment centers, etc. . Responds to more complex cases and account specific requests. . Uses appropr...

a week ago seen See more...

Business Information Developer Consultant (Level 3 Data Engineer)

Elevance Health

RICHMOND, VA

Establish connectivity to operations source systems and data repositories. . Conduct data discovery work to understand strengths, limitations, and opportunities within the available data. . Build an increasingly comprehensive und...

a week ago seen See more...

Grievance/Appeals Representative II

Elevance Health

Woburn, MA

Conducts investigation and review of customer grievances and appeals involving provision of service and benefit coverage issues. Contacts customers to gather information and communicate disposition of case; documents interactions...

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Marketing Communications Manager

Elevance Health

INDIANAPOLIS, IN

Builds market product / marketing plans. . Assists in product pricing assessment and recommendations. . Serves as a single point of contact on marketing issues and resolution. . Coordinates the development and review of communica...

a week ago seen See more...

Registered Nurse-Oncology

Elevance Health

HOUSTON, TX

Performs duties within the Nurses scope of practice, the facilitys policies/procedures, INS Standards of practice, and approved facility protocols. . Mix and administers ordered therapies according to prescriber order, facility...

a week ago seen See more...

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