Provider Reimbursement Policy Manager – Patient Safety

Elevance Health

Provider Reimbursement Manager responsible for managing reimbursement strategy and policy at Elevance Health. Ensuring accurate claim adjudication and leading policy development for behavioral health reimbursement.

Posted 7/14/2026full-timeIndianapolis • Florida, Kansas, Kentucky, Montana, Ohio, Texas, Virginia • 🇺🇸 United StatesSeniorLead💰 $80,940 - $134,190 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider reimbursement strategy and policy development, with a strong focus on financial modeling, economic analysis, and compliance with coding standards. Capable of leading initiatives that enhance cost efficiency and improve service delivery in healthcare settings.

Highest-signal resume keywords

Provider Reimbursement StrategyFinancial ModelingCPC - Certified Professional CoderICD-9/10CM CodingResearch and Analysis

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Reimbursement Policy DevelopmentCost of Care AnalysisEconomic AnalysisBilling Rules TranslationClaims Adjudication

Soft Skills

Strong Written CommunicationStrong Verbal Communication

Certifications & Qualifications

CPC - Certified Professional Coder

Industry Keywords

Behavioral Health ReimbursementPatient Safety ExperiencePricing MethodologiesMS-DRGAP-DRGAPR-DRG

About the role

Key responsibilities & impact

responsible for managing key components of the provider reimbursement strategy and policy
Ensures accurate adjudication of claims
translating various complex coding, business and billing rules and standards into effective and accurate reimbursement policies
Serves as subject matter expert regarding reimbursement policies
Leads policy development for specific plan(s) and/or the development and implementation of behavioral health reimbursement policy rules
Works with the multiple business areas to ensure that accurate cost of care targets are incorporated into the company's financial plans
Performs and/or directs complex research to ensure that projected changes meet corporate cost targets
Prepares and presents cost of care data analysis to support the regions cost of care initiatives
Develops and maintains the provider reimbursement policies that will lower the cost of care, improve service, and reduce administrative expenses
Manages special projects and initiatives

Requirements

What you’ll need

Requires a BA/BS degree in a related field
a minimum of 7 years reimbursement experience
performing detailed financial modeling and economic analyses
CPC - Certified Professional Coder strongly preferred
RN/Clinical background preferred
Patient Safety Experience preferred
Understanding of pricing methodologies
working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG
Strong research and analysis experience preferred
Strong written and verbal communications

Benefits

Comp & perks

comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution
Paid Time Off
wellness programs
financial education resources