Elevance Health

Data Analyst

• Partner with the team and stakeholders to manage and surface new insights around the voice of the customer
• Perform established analysis for routine diagnoses of quality, use, cost and other variables to find new opportunities for improvement
• Evaluate existing digital products and competitor and industry data to improve existing products and make recommendations for new products
• Partner with business stakeholders and IT to determine the best solutions to enhance functionality and increase user satisfaction, solve member problems, and meet other goals
• Participate in the Agile Scrum process to ensure product solutions are fulfilled

Data Analytics Intern

Journalist

• Responsible for elevating and enhancing content marketing efforts on Elevance-owned platforms
• Helps create and bring to life enterprise thought leadership messaging
• Researches, writes, edits, and reviews content for Elevance owned channels and social platforms
• Identifies content topics that ladder up to the thought leadership platform’s topics and themes
• Pitches new ideas to the core Enterprise Content Marketing Strategy team
• Creates relationships with contacts and sources inside and outside of the organization that could potentially be featured in content
• Collaborates with Elevance Brand Team, Corporate Communications, and other lines of business to inform topics and article content
• Participates and acts as a leading voice within the Enterprise Editorial Council
• Ensures that marketing efforts are connected and aligned to the Enterprise messaging platform
• Ensures all materials meet internal and external business and legal standards

Enterprise Editorial Journalist

Marketing

• Responsible for providing advanced strategic marketing direction and market intelligence.
• Develops and implements marketing plans.
• Partners with other marketing areas and sales force in support of marketing goals.
• May lead the strategy and creation of marketing collateral to meet client needs.
• Oversees marketing strategies and executes marketing tactics to support business/sales objectives.

Senior Marketing Coordinator

Sales

• Develops processes for consistency
• Manages sales support activities which may include one or more of the following functions: broker call center, sales support staff, field service, sales training and technology, broker administration, proposals, product development, or material distribution
• Hires, trains, coaches, counsels, and evaluates performance of direct reports

Manager II, Sales Support

Manager

• Performing care management within the scope of licensure for members with complex and chronic care needs
• Assessing, developing, implementing, coordinating, monitoring and evaluating care plans designed to optimize member health care across the care continuum
• Performing duties telephonically or on-site such as at hospitals for discharge planning
• Ensuring members understand benefits and assist in access of services appropriate to their health needs
• Conducting assessments to identify individual needs and a specific care management plan
• Implementing care plan through actions based on assessments including providing education
• Coordinating internal and external resources to meet identified needs
• Monitoring and evaluating effectiveness of the care management plan and modifying as necessary
• Interfaces with Medical Directors and other health professionals on the development of care management treatment plans
• Assisting in problem solving for members and providers related to access to care, vendors, claims or service issues

Telephonic RN Case Manager I

Underwriter

• Responsible for the underwriting and pricing of stop loss coverage for new and existing members
• Monitors and manages profitability of renewal and prospect employer groups in accordance with Corporate Guidelines
• Oversees issuance of standard financial arrangement contracts and creates wording for non-standard or new financial arrangements related to stop loss coverage
• Works with actuaries to develop and implement pricing of stop loss prospects and renewals
• Utilizes in-depth knowledge of formulas, trending, reserving procedures and claims to implement and consult with sales staff on the appropriateness of specific financial arrangements, ASO arrangements and reinsurance provisions
• Develops and participates in training of Specialty and Health Sales staff

Stop Loss Underwriting Manager

Consultant

• Calculates stop loss rates for large complex cases based on thorough analysis of experience, location, demographics, etc.
• Coordinates with other departments to ensure accuracy and consistency of overall account reporting.
• Proposes rates for prospective business utilizing a combination of other carrier experience, demographic data and manual rates.
• Performs post-sale reviews.
• Prepares or supervises preparation of annual settlements, rate projections, or benefit change increments and decrements.
• Surveys existing product portfolios by market, monitors sales results, trends and needs, recommends product portfolio changes.
• Assists in establishing rating and administrative procedures.
• Participates in major multi-functional teams as underwriting representative.
• Assists in the technical development of underwriting associates, which may include monitoring reports and work flow to provide recommendations on productivity and efficiency improvements.
• Updates and monitors departmental processes and procedures in compliance with system, regulatory and business requirements.

Senior Stop Loss Group Underwriter Consultant

Software Engineer

• Interfaces with key internal and external technology partners; develops strategies and facilitates execution of business objectives
• Develops Technology Plan and Forecast for enterprise applications, enterprise-wide tools, infrastructure, and manages day to day operations for a major portion of a functional area
• Ensures disaster recovery and business continuity plan are implemented, monitored, and updated on a recurring basis
• Works directly with Information Security to help enforce proper policies and controls
• Directs multiple work functions/applications or major projects/programs with broad scope and strategic business impact
• Establishes business objectives and integrates operational plans
• Negotiates the resolution of intra-organizational issues in the balanced best interests of the business
• Establishes and maintains collaborative relationships with key business partners
• Hires, trains, coaches, counsels, and evaluates performance of direct reports

Director of Engineering

Director

• facilitate the execution of the Enterprise Plan to Win Portfolios
• ensure alignment with the multi-segment business model
• partner with the Enterprise Strategy team to implement appropriate business model
• monitor projects, ensuring program meets milestones, deliverables, budget and objectives
• provide expert knowledge of roadmaps and strategic view of enterprise dependency
• influence and provide leadership on external advocacy efforts
• collaborate to utilize lean capabilities for projects, tools and methodologies
• manage requirements, strategic projects, reports, analysis, and deadlines
• create internal and external communication strategy
• work across matrix teams to ensure changes are communicated and executed

Provider Network Management Director

• creating a partnership relationship with providers and other initiatives
• implementing the concept of a Medical Home for our members
• assessing current practice patterns, assets and challenges
• in partnership with the PCP, evaluating results of the initial assessment
• establishing a project plan with the practice

Practice Consultant

Inside Sales

• Manages and mentors inside sales staff
• Reviews referral activity trends and aligns inside sales activities to business goals
• Uses databases and other tools to identify key accounts and maximizes referral potential
• Partners with outside sales team
• Communicates information regarding competitors, issues affecting inside sales, and related information to leadership
• Hires, trains, coaches, counsels, and evaluates performance of direct reports

Manager, CarelonRx Inside Sales

• Leads the analysis of current and projected product lines to determine optimal business strategy.
• Oversees research, analysis and the development of recommendations on the external environment as part of the development of strategic business plans.
• Analyzes major competitor strategies.
• Identifies and monitors changing patterns of competition and recommends response.
• Acquires and maintains data/information on market, industry, economic, consumer and competitive conditions and trends pertaining to health insurance/managed care and related services.
• Consolidates data, analyses and recommendations into concise business plans.
• Develops and implements project plans and oversees project resources.
• Leads the activities of lower level staff performing related functions.
• Travels to worksite and other locations as necessary.

Market Intelligence Manager

Bilingual

• Provides urgent health care via telephone and tele video modalities to patients
• Develops and implements clinical plans of care for adult patients facing chronic and complex conditions
• Gathers history and physical exam and diagnostics as needed
• Identifies and closes gaps in care
• Meets the patient’s and family’s physical and psychosocial needs
• Educates patients and families about medication usage, side effects, illness progression, diet, and nutrition
• Maintains contact with other clinical team members and other medical providers to coordinate optimal care and resources
• Maintains patient medical records and medical documentation
• Participates in continuing education as required by state and certifying body
• Prescribes medication as permitted by state prescribing authority

Bilingual Nurse Practitioner, Virtual

Medical Director

• Responsible for the administration of physical and/or behavioral health medical services
• Provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations
• Conduct peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations
• Serve as a resource and consultant for other areas of the company
• Parses through medical policies and clinical guidelines
• Lead, develop, direct, and implement clinical and non-clinical activities that impact health care quality cost and outcomes

Strategy

• Business Change Director responsible for working with management to identify and implement varied projects, programs and plans that support the achievement of business unit and enterprise goals
• May specialize in one area of organization effectiveness or be assigned to directly support a business unit
• Identifies potential issues, project change, and scope data
• Leads efforts to identify best practices
• Identifies impacted parties, business partners, and resources required
• Develop and designs processes and systems that support business needs
• Designs methods for integrating functions and processes
• Conducts cost/benefit analysis
• Builds support for business change throughout the business unit
• Provides process, project, and change management methodology coaching/consulting support to both local and enterprise-wide initiatives
• Leads the project prioritization and scheduling activities for the business unit
• Provides expertise to the business areas in culture/change management activities
• Supports the execution of the operating plan