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DIRECTOR OF NATIONAL QUALITY MANAGEMENT

Develops, implements, and leads an industry leading quality improvement program for the Wellpoint product in Massachusetts ensuring that all performance guarantee metrics and client requirements are met and/or exceeded. Designs, a...

CompanyElevance Health
AddressWOBURN, MA
CategoryManufacturing
Date Posted 2 weeks ago See detail

Director of National Quality Management

Elevance Health

WOBURN, MA

Develops, implements, and leads an industry leading quality improvement program for the Wellpoint product in Massachusetts ensuring that all performance guarantee metrics and client requirements are met and/or exceeded. Designs, a...

2 weeks ago seen See more...

Administrative Assistant- Ambulatory Infusion

Elevance Health

LUBBOCK, TX

Oversees staff and processes for check-in, verifying charts are pulled for scheduled appointments, demographics/eligibility is updated, and current forms are being utilized. . Listens and responds to patient and/or family members...

2 weeks ago seen See more...

Manager II Grievance/Appeals (RN)

Elevance Health

WOODLAND HILLS, CA

Description Manager II Grievance/Appeals Claims Support Location: *CA Residential Requirement This position will work a hybrid model (remote and office). This range may be modified in the future and actual compensation may var...

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Director Proposal Development

Elevance Health

Mason, OH

Negotiates, administers, extends and renegotiates proposals . Formulates and coordinates data collection process . Directs and coordinates activities of staff engaged in writing proposals . Evaluates and monitors proposal perform...

2 weeks ago seen See more...

Pharmacy Customer Associate - BioPlus Specialty Pharmacy

Elevance Health

DENVER, CO

Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the...

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Security Operations Center Specialist

Elevance Health

INDIANAPOLIS, IN

Ensuring physical security systems remain operational across the enterprise, activating and/or responding to alarms, receiving calls regarding security-related incidents occurring within the company, creating incident reports util...

2 weeks ago seen See more...

Business Information Developer Consultant

Elevance Health

NORFOLK, VA

Works with Data Science/Carelon Digital to develop Clinical Artificial Intelligence (AI) solutions for the Medical Management team. . Leverages Large Language Models (LLMs) to develop and implement solutions. . Leverages clinical...

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Nurse Appeals (RN)

Elevance Health

WOODLAND HILLS, CA

Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes medical...

2 weeks ago seen See more...

Customer Care Representative I, II - Dental

Elevance Health

LAS VEGAS, NV

Description Title: Customer Care Representative I, II Location: Las Vegas, NV, Colorado Springs, CO, Des Moines, IA, or Gilbert, MN. Affordable Health Insurance, Dental, Vision and Basic Life 401K match, Paid Time Off, H...

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Release Management Advisor

Elevance Health

COLUMBUS, OH

Provides analysis and insight to Release Management teams planning, leads the release planning meetings for multiple platforms and project releases and prepares and publishes release notes and communicates success or failure of...

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Outreach Care Specialist Lead

Elevance Health

Indiana, 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...

2 weeks ago seen See more...

LTSS Service Coordinator - Clinician

Elevance Health

Roanoke, VA

Assists responsible RN in identifying members for high risk complications. Obtains clinical data as directed by the responsible RN. . Assists the responsible RN in identifying members that would benefit from an alternative le...

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Registered Nurse - Ambulatory Infusion

Elevance Health

CINCINNATI, OH

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

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Mgr II HCMS

Elevance Health

Washington, United States

Engages in the development and implementation of integrated medical management programs across the different member population types covered by the health plan. Ensures continued compliance with specific medical management standa...

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Compliance Consultant

Elevance Health

NASHVILLE, TN

At the advanced level, report, communicate, research laws at the advanced level, regulations, requirements, regulatory audits and/or exams. . Provide advanced level support to regulatory audits or exams, internal audits, accredit...

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Whole Health Director

Elevance Health

COLUMBUS, OH

Establishing, informing, monitoring, and accomplishing the health plans integrated Whole Health strategy under the direction of the State Plan President. Championing integration and articulating the goals and value of our compreh...

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Manager II Systems Support & Programs

Elevance Health

NEW YORK, NY

Manages the day-to-day reporting activities of the Business Solutions area of Health Plan Services. . Analyzes business requirements and objectives towards determining the optimal configuration of the requirements used to support...

2 weeks ago seen See more...

Behavioral Health Consultant II

Elevance Health

NEWTON, MA

For the MA Behavioral Health Helpline, takes inbound calls, texts and chats who may be in crisis. Performs safety screenings and assessments to discern presence and acuity of risk to the safety of the individual or others. . Uses...

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Subrogation Examiner

Elevance Health

LOUISVILLE, KY

Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party. . Responds to inquiries regarding information on injury claims...

2 weeks ago seen See more...

Health Policy Director

Elevance Health

INDIANAPOLIS, IN

Maintains a portfolio of public policy issues related to pharmacy and infusion policy. . Leads related public policy activities focused on pharmacy and infusion issues including: . Develops positions that support enterprise objec...

2 weeks ago seen See more...

Nurse Care Mgr I

Elevance Health

Miami, FL

Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of network services, and appropriateness of treatme...

2 weeks ago seen See more...

Identity and Access Management (IAM) Security Senior Advisor

Elevance Health

NORFOLK, VA

Write and deploy code to downstream applications such as SailPoint. . Provision infrastructure as code for the automated identity management system. . Support internal SLAs (Service Level Agreements) to deliver automated identity...

2 weeks ago seen See more...

Reviewer - Therapy Services

Elevance Health

PALO ALTO, CA

Follows the system guidelines that makes decisions on approval for care for a patient. . Processes system generated decisions for authorization requests, meeting all contract requirements, processes, and operational unit goals to...

2 weeks ago seen See more...

Systems Analyst Senior (US)

Elevance Health

PLANO, TX

Manages integrated functionality, usability, reliability, performance, and support requirements of a system. Creates feature test strategies and environment needs. Provides the link between the technical and business views of the...

2 weeks ago seen See more...

Registered Nurse-Ambulatory Infusion

Elevance Health

DALLAS, TX

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

2 weeks ago seen See more...

Senior Outreach Care Specialist

Elevance Health

Indianapolis, IN

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...

2 weeks ago seen See more...

Sr. Process Improvement Engineer

Elevance Health

CHICAGO, IL

Provides Process Improvement methodology expertise to associates and team members across the organization. . Collaborates with cross-functional teams in the identification, research, and implementation of Process Improvements. ....

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Pharmacy Tech II

Elevance Health

Oregon, United States

Verifies member information and inputs data for the pharmacists. . Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs. . Processes prior authorization requests from p...

2 weeks ago seen See more...

Contract Administrator Ld

Elevance Health

NORFOLK, VA

Develops and oversees the regulatory approval process for submission of health insurance products with federal and state insurance regulators. Collaborate with multiple functional business areas (enterprise and local senior manage...

2 weeks ago seen See more...

Provder Operations Director

Elevance Health

NEW YORK, NY

Provide subject matter expertise in regard to strategic initiatives, may act as a liaison to IT or other internal and external business partners, be a corporate single point of contact, and mentor regional subject matter experts....

2 weeks ago seen See more...

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