Revenue Cycle Management Consultant – CarelonRx

Elevance Health

RCM Consultant at Elevance Health focusing on revenue cycle management and operational improvements in pharmacy; enhancing compliance and efficiency across teams.

Posted 6/23/2026full-timeCincinnati • Florida, Ohio, Virginia • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Develop and maintain enterprise or function-level revenue cycle standards, policies, procedures, and governance practices to support consistent execution and compliance.
Evaluate revenue cycle operations across teams and sites, identify structural improvement opportunities, and recommend reengineered workflows and operating models.
Advise leaders on automation opportunities across eligibility, authorization, claim edits, denial prevention, appeals, payment posting, underpayment detection, and work queue routing.
Lead complex cross-functional initiatives involving process standardization, technology enablement, performance management, and organizational change.
Design rollout plans, audit-ready controls, KPI dashboards, and governance cadences to ensure improvements are sustained post-implementation.
Serve as a subject matter expert for RCM best practices, payer rules, revenue leakage risk, and scalable operating design.

Requirements

What you’ll need

In depth revenue cycle experience, in pharmacy preferred
Experience in consulting, shared services, multi-site healthcare, or enterprise transformation environments
Exposure to automation tools, workflow orchestration, analytics platforms, or AI-enabled RCM solutions
Experience supporting policy standardization and operational redesign across multiple business units or functions

Benefits

Comp & perks

merit increases
paid holidays
Paid Time Off
incentive bonus programs
medical
dental
vision
short and long term disability benefits
401(k) +match
stock purchase plan
life insurance
wellness programs
financial education resources

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

revenue cycle managementprocess standardizationoperational redesignworkflow orchestrationanalyticsautomationKPI developmentgovernance practicesperformance managementcross-functional initiatives

Soft Skills

leadershipadvisory skillsorganizational change managementcommunicationproblem-solvingcollaborationstrategic thinkinganalytical skillsproject managementstakeholder engagement