Solution Director, Specialty Medication Mgmt
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.
Carelon Medical Benefits Management Product organization is looking to hire a Solution Management Sr Director. This high-performing individual contributor will lead the expansion of our specialty medication UM platform. S/he will lead this solution and platform build alongside Carelon Legal, HR, Compliance, Contracting, Network, Product, Clinical Development, IT, Operations, Audit, and Accreditation teams. This meaningful expansion will enhance Specialty Medication Benefits Management and the Provider/Prescriber UM experience through a digital-first solution that will allow clinicians to obtain real-time approval for all specialty medications with a single request.
This position can work in a hybrid way from any US Elevance Health corporate location.
Responsible for leading the development, implementation, and ongoing management of complex solution strategies for a business product line across the enterprise or within a multi-state environment.
How you will make an impact:
Develops, implements and maintains competitive solution platform.
Partners with product managers to achieve superior execution of solution product strategy in the marketplace.
Tracks individual solution performance by benefit design, market segment and sub region.
Supports the development of short and long term strategic solution plans in support of market, sales and profitability objectives.
Identifies system needs to support short and long term solution strategy.
Develops system requirements and ROI.
Will lead effort or manage project teams in the implementation of complex regional and companywide initiatives including portfolio repositioning in a market, legislative changes, network/provider changes/ medical management program and policy initiatives, etc.
Requires a BA/BS degree and a minimum of 7 years of related experience; or any combination of education and experience, which would provide an equivalent background.
Highly preferred skills and experiences:
Expertise in the Specialty Medication UM Review Process, Requirements, and Management.
Experience with high-cost specialty medications, drug delivery, site-of-care, and medical/pharmacy benefit management.
Experience in the development and implementation of new concepts, techniques, and standards.
Preferred experience in clinical program design.
Preferred project management experience
Exceptional skills in Planning, Organization, and Priority Management.
The ability or desire to lead a large team towards a unified goal with new/different abilities (Change)
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $119,360 to $214,848
Locations: California; Colorado; 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, nondiscriminatory 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 email@example.com assistance.