Elevance Health Process Expert Sr in Jacksonville, Florida
Process Expert Sr
Location: Florida, Florida
Job Family: BSP > Process Improvement
Type: Full time
Date Posted:Jun 23, 2022
Req #: PS75255
DescriptionSupports multiple operations departments by participating in project and process work. Primary duties may include, but are not limited to:
• Research operations workflow problems and system irregularities; develops, tests, presents process improvement solutions for new systems, new accounts and other operational improvements.
• develops and leads project plans and communicates project status.
• provides process direction and decision making for all minor and major project work.
• provides guidance to process experts.
• May perform duties as a lead when involved with enterprise-wide initiatives/projects.
• Supports development, management and oversight of market audits, readiness, workflows, information requests, process improvement solutions for market issues.
• Supports development and maintenance of administrative pharmacy policies and standard operating procedures in each market to ensure compliance with federal and state guidance and regulations.
• Performs oversight of the process and outcomes of internal review of adverse determination pharmacy letters to ensure compliance with NCQA, URAC and Enterprise best practices.Qualifications
Requires a BA/BS
5 - 8 years’ experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background.
Ability to analyze and design workflows, processes, supporting systems and procedures and identify improvements strongly preferred.
Ability to work on a high function team and respond appropriately to high priority situations
Ability to self-manage and prioritize multiple projects and priorities; and communicate openly and constructively regarding work on team meetings and with a supervisor.
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. 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 email@example.com assistance.
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