Solutions Management Director - Utilization Management

Description

Solutions Management Director - Utilization Management

Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

Hybrid Workplace Strategy: 1-2 days in office per week

The Solutions Management Directoris responsible for leading the planning and implementation of products and services for the most complex, diverse lines of business enterprise wide. Serves as the single point of contact and subject matter expert on all aspects of planning, implementing and managing day to day operational, technical and business partner interactions for existing programs and works together with Product Development to consult on enhancements to existing products and development of new clinical solutions based on department analytics.

How you will make an impact:

• Provides consultation and advice to business partners regarding benefits of products and analytics. Explains timelines and measures of success for implementing these products.
• Coordinates with the Physician Liaison regarding clinical issues related to clinical measure implementation or customization by line of business and communicates changes to Product Development for consideration in product performance and financial analyses.
• Schedules and coordinates implementation of contracted products and services for assigned business partners.
• Coordinates data requirements, production schedules and deliverables with the business partner.
• Oversees all business partner specifications and/or modifications for contracted products and services.
• Provides business partners with the resources, training and services necessary to effectively utilize the products that provides.
• Analyzes business partner data for QA and identification of opportunities for business partners to utilize products and services to improve plan performance.
• Maintains expert knowledge of current clinical measures and future clinical measure development plans, communicates this information to business partners, assists in the selection of clinical measures to be utilized in pilot and full rollout of products and services, and guides business partners in continually reviewing and updating clinical measure sets.
• Maintains expert knowledge of all current systems, products and services and basic understanding of future system and product development plans to allow appropriate level of communication with business partner.
• Leads department projects and mentors Solutions Management staff.
• Provides leadership to managers and consultants.
• Serves as subject matter expert for the department.
• Directors typically support business strategies through an integrated portfolio of programs, projects and initiatives.

Minimum Requirements:

Requires a BA/BS and minimum of 8 years experience in a related field, including minimum of 3 years Solutions Management experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills & Abilities:

• CRM platform and Utilization Management platform integration experience

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $111,920 to $201,456

Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

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 Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

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. 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.comfor assistance.