Strategy & Program Development Director, Payment ...

Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Strategy & Program Development Director will lead Payment Integrity (PI) performance insights ideation and the initiation of the overarching strategy for this team. This Director will be responsible for key strategic development, leading multiple major projects, and developing a multi-year roadmap inclusive of technology, infrastructure, and incremental revenue through cost-of-care savings and new audit concepts. The Strategy & Program Development Director will be the leader driving the strategic future planning and development for the PI insights and ideation team. The ideal candidate will bring innovative ideas, strategic thought leadership, and project management acumen to the role to ensure the team meets its goals and drives ongoing growth and compliance. This position can work in a hybrid way from any US corporate Elevance Health location. How you will make an impact: Develop a deep understanding of the full scope and responsibilities of the Payment Integrity Ideation and Insights organization. Develop and lead the annual strategic planning and roadmap for Payment Integrity Ideation, encompassing the implementation of ongoing tools, team workflows, and collaborative efforts. Create and support regular ideation discussions with PI functional leaders to foster ongoing collaboration and incremental value generation. Research new ventures and prospective revenue expansion opportunities. Lead the creation of industry-best audit concept visibility and metrics for Elevance Payment Integrity and its customers. Also, monitor legislation and advise senior management relative to compliance. Travels to worksite and other locations as necessary. Requires a BA/BS degree in a related field and a minimum of 10 years of related experience including 5 years of leadership experience; or any combination of education and experience, which would provide an equivalent background. Highly preferred skills and experiences: -Expertise in healthcare payment integrity business. -Experience with strategic ideation development, strategy growth planning, and revenue growth planning. -Project Management expertise such as PMP working at the portfolio level; this role will lead multiple projects simultaneously. -Advanced graduate degree. 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 for assistance.

Created: 2024-10-19