Solutions Management Director
This positions location is flexible. The expectation will be that the Business Analyst III is within 50 miles of an Elevance Health location. This position will report to the office 0-3 times per month.
A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.
A proud member of the Elevance Health family of companies, Carelon Post Acute Solutions, formerly myNEXUS, is the leader in health resource optimization, focused on transforming how healthcare is delivered and promoting the advancement of care for the people we serve.
The Solutions Management Director is 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.
- 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, Capabilities and Experinces:
- Graduate degree and/or professional designation related to field preferred.
- Project/Product management experience and certifications preferred.
- Healthcare/Prior Authorization expereince strongly preferred.
- Leading BA/Product owners
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; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY
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 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. A Fortune 20 company with a longstanding history in the healthcare industry, 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 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 – 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. 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 firstname.lastname@example.org for assistance.