Description
LOCATION: This is remote from home opportunity supporting NC Medicaid. Eastern or Central Time zone located candidates are preferred.
HOURS: General business hours, Monday through Friday.
Responsible for generating process improvements that bring about measurable improvement in quality and/or efficiency. Contributes to achieve department’s objectives by serving as key contact for researching and implementing solutions and tools for new systems and other key operational improvements, provide guidance to leads, operations experts, associates, and/or managers on process improvement issues.
Primary Duties May Include, But Are Not Limited To
- Represents the department on process improvement teams, special projects and implementation of new technology.
- Lead role in coordinating annual review/revision of procedures.
- Leads the training of associates when new processes or procedures are implemented.
- Communicates process information and facilitates workgroups to ensure accurate and consistent workload reporting.
- Review /analyze monthly workload reports to ensure goals are on-target (timeliness, backlog) across all operational sites.
- Identify areas of concern & implement corrective plans if necessary.
- Uses reports and production statistics to represent unit(s) in departmental process improvement and system changes and provides specialized input on reports to management.
Required Qualifications
- Requires a BA/BS in a related field and minimum of 5 years related experience; or any combination of education and experience, which would provide an equivalent background.
- Ability to travel may be required.
Preferred Qualifications
- Experience interacting confidently with senior management or state representatives, as a subject matter expert, is a must!
- Must be comfortable influencing decision-making.
- Previous experience in high-volume operations (Medical Review, Appeals, Claims, Customer Service) strongly preferred.
- Demonstrated ability to analyze existing and potential workflows, processes, supporting systems, and procedures and identifying improvements strongly preferred.
- Excellent oral, written, and interpersonal communication skills, strong analytical, organizational, planning, problem solving, and project/decision facilitation skills strongly preferred.
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 ability@icareerhelp.com for assistance.