Elevance Health

Manager

• Responsible for care management within the scope of licensure for members with complex and chronic care needs
• Conduct assessments to identify individual needs and develop a specific care management plan
• Implement care plan by facilitating authorizations/referrals as appropriate
• Coordinate internal and external resources to meet identified needs
• Monitor and evaluate effectiveness of the care management plan and modify as necessary
• Interfaces with Medical Directors and Physician Advisors on care management treatment plans

Nurse Case Manager I

Content Marketing Manager

• Leads fee schedule development for specific plan(s) and/or the development and implementation of clinical editing rules
• Works with business partners to assist with cost of care claim editing goals
• Performs and/or directs complex fee modeling exercises to ensure that projected unit reimbursement changes meet corporate cost targets
• Review healthcare policy (Medicaid manuals, fee schedules, CCI, OIG Alerts, LCAs/LCDs, NCDs, Medicare manuals, etc.) for coding and billing guidelines that can be turned into software editing rules
• Create billing edits that provide clients with monetary savings and promote coding accuracy
• Prepares and presents cost of care data analysis to support the regions cost of care initiatives
• Develops and maintains the provider reimbursement strategy that will lower the cost of care, improve service, and reduce administrative expenses
• Manages special projects and initiatives

Clinical Content & Reimbursement Director

Analyst

• Owns and performs the financial modeling and development of the target projection model
• Conducts target valuation and financial return analysis
• Supports the due diligence processes
• Performs financial statement analysis and provides guidance to junior associates
• Conducts industry, market, and competitor analysis for M&A opportunities

Senior M&A Analyst

Engineer

• Responsible for end to end application, system development and maintenance on medium or semi complex technology platforms
• Build and maintain cloud-native services using microservices / modular monolith patterns
• Develop REST/GraphQL APIs and asynchronous workflows using event-driven architecture and messaging patterns
• Implement data access and processing using SQL/NoSQL stores and caching strategies for performance and cost efficiency
• Create high-quality, testable code with strong unit/integration/contract test coverage and automation-first mindset
• Deliver through modern CI/CD pipelines and Infrastructure as Code (IaC)
• Containerize applications and deploy on Kubernetes, supporting service discovery, autoscaling, and safe releases
• Collaborate with product, architecture, security, and SRE teams to shape technical solutions and continuously improve engineering maturity

Engineer II

Business Analyst

• Analyzes business needs to determine optimal means of meeting those needs
• Determines specific business application software requirements to address specific business needs
• Works with programming staff to ensure requirements will be incorporated into system design and testing
• Acts as liaison with users of the software to address questions/issues
• Assists in maintaining operational reports and documentation
• Applies tools and processes consistently across assigned tasks
• Collaborates with team members to support quality and operational goals
• Develops skills in analytics, reporting, and continuous improvement processes

Business Analyst II

Software Engineer

• Responsible for maintaining and implementing the technology strategic solutions related to end to end application and system development, delivery, testing, and support within assigned client group
• Drive enterprise-wide solution architecture strategy across complex, multi-system ecosystems, ensuring alignment with business outcomes and modernization goals
• Influence senior executive stakeholders and cross-functional leaders to adopt scalable, future-ready technology solutions
• Translate strategic architecture vision into pragmatic, executable roadmaps that accelerate delivery and mitigate risk
• Lead the design and adoption of modern architectures, including cloud-native, API-first, event-driven, and data-centric platforms
• Champion AI, automation, and platform engineering initiatives to enable innovation, operational efficiency, and competitive differentiation
• Establish strong governance practices, ensuring compliance, risk management, and adherence to enterprise architecture standards
• Provide hands-on architectural guidance where needed, while empowering teams to execute with autonomy and accountability
• Foster a culture of engineering excellence, architectural discipline, and continuous innovation across the organization

Engineering Manager II

• Maintain and implement technology strategic solutions related to application and system development
• Define and implement end-to-end quality assurance and quality engineering strategy
• Establish quality standards, metrics, and governance models
• Scale test automation frameworks and integrate quality practices into CI/CD pipelines
• Influence engineering, product, architecture, and operations teams to embed quality ownership
• Implement risk-based testing approaches and ensure testing processes meet regulatory requirements
• Build, mentor, and lead high-performing QA and Quality Engineering teams

Account Executive

• Responsible for all sales activities in specified territory
• Builds and maintains relationships with key customers
• Works with leadership to develop sales forecasts and goals
• Qualifies opportunities in the territory with insurance plans
• Identifies and resolves customer service issues
• Networks with industry partners
• Assists in closing deals and negotiating deliverables

• performing care management within the scope of licensure
• assessing, developing, implementing, coordinating, monitoring, and evaluating care plans
• ensures member access to services appropriate to their health needs
• conducts assessments to identify individual needs
• implements care plan by facilitating authorizations/referrals
• coordinates internal and external resources to meet needs
• monitors and evaluates effectiveness of the care management plan
• interfaces with Medical Directors and Physician Advisors
• negotiates rates of reimbursement
• assists in problem solving with providers, claims or service issues

Nurse Case Manager

Financial Planning and Analysis

• Develops and manages detailed financial forecasts, budgets, and plans for various products
• Produces clear, well-formatted reports for various audiences
• Develops and maintains financial reports to communicate actual results and variances to budget
• Supports monthly close process including summarizing and consolidating results versus budget and forecast
• Works with management to provide decision support analysis
• Conducts and documents complex financial and business related analyses

Senior Financial Consultant

Director

• Leads strategy and implementation of new or enhanced PBM products, including clinically driven solutions, UM programs, and integrated product bundles across Commercial and government segments
• Partners with cross-functional leaders (Clinical, Actuarial, Trade Relations, Operations, IT, Sales, and Medical partners) to deliver aligned, enterprise-wide product strategies that meet both clinical and financial objectives
• Drives product roadmap execution with a focus on accelerating speed-to-market, reducing product lifecycle timelines, and prioritizing high-impact, revenue-generating opportunities
• Monitors specialty drug pipeline, biosimilars, emerging therapies, and market innovations to inform product strategy and identify opportunities for differentiation or gap closure
• Evaluates current product portfolio performance, identifying opportunities to enhance, sunset, or expand offerings to improve adoption, utilization, and profitability
• Ensures all products are compliant with regulatory directives, state/federal laws, and evolving PBM transparency requirements
• Coordinates the communication, presentation, and implementation of all phases of product development, including go-to-market readiness and stakeholder alignment
• Serves as a subject matter expert for clinical product capabilities, representing product strategy in client, partner, and executive-level discussions
• Collaborates across matrix partners to break down silos and deliver integrated pharmacy and medical solutions, including supporting growth in ASO and integrated product offerings
• Monitors competitive, regulatory, economic, and industry trends to proactively assess product impacts, risks, and opportunities

Product Development Director

• Managing psychiatric disorder facility-based and outpatient professional treatment health benefits through telephonic or written review
• Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines
• Refers cases to Peer Reviewers as appropriate
• Performs psychiatric disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources
• Will serve as a resource to other BH Care Managers
• Assists with more complex cases and may participate in inter and intradepartmental teams’ projects and initiatives

Behavioral Health Care Manager II – Autism, ABA/BCBA

Medical Director

• Supports clinicians to ensure timely and consistent responses to members and providers.
• Provides guidance for clinical operational aspects of a program.
• Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations and patients’ office visits with providers and external physicians.
• May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.
• Serves as a resource and consultant for other areas of the company.
• May be required to represent the company to external entities and/or serve on internal and/or external committees.
• May chair company committees.
• Interprets medical policies and clinical guidelines.
• May develop and propose new medical policies based on changes in healthcare.
• Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality, cost, and outcomes.
• Identifies and develops opportunities for innovation to increase effectiveness and quality.
• Travel to an office for in-person meetings when necessary.

Behavioral Health Medical Director – Psychiatrist

• ensuring tax accounting matters are timely and accurately addressed
• assisting the tax director with the quarterly and annual income tax provision process under ASC 740
• preparing related tax disclosures for statutory or GAAP financial statements
• maintaining and reconciling deferred tax balances
• researching and analyzing tax developments
• assisting or leading other tax department activities

Tax Manager

Bilingual

• Reviewing and prioritizing patient census.
• Reaching out to patients to explain services and enrolling them into the appropriate programs based on the line of business.
• Coordinate with internal teams, including clinical and care coordination teams, to ensure seamless patient onboarding.
• Meet or exceed enrollment targets and key performance indicators.
• Providing support by addressing inquiries and scheduling the initial and annual appointments.
• Enters documentation into the designated systems.

Nurse Case Manager I

Clinical Content & Reimbursement Director

Senior M&A Analyst

Engineer II

Business Analyst II

Engineering Manager II

Engineering Manager II

Account Executive

Nurse Case Manager

Senior Financial Consultant

Product Development Director

Behavioral Health Care Manager II – Autism, ABA/BCBA

Behavioral Health Medical Director – Psychiatrist

Tax Manager

Patient Enrollment Specialist I – Bilingual Spanish