All Metro Health Care jobs - 51 jobs

Sign-On Bonus: $3,000 The Therapy Services Specialist (Bilingual Korean Required) is responsible for working under the guidance of occupational therapist, collaborate with the managed care organization to support persons aging in place receiving home or community-based services. Location: Virtual - This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. How you will make an impact: * Performs telephonic and/or virtual assessments to identify participants needs. * Provides recommendations to MCO for type and hours of supportive services required. * Conduct objective assessments for program participation to determine the appropriate level of support and services required. * Obtain participant history to inform the comprehensive assessment. * Complete assessments annually or more frequently as needed in accordance with applicable program requirements and participants needs. * Educate program participants and MCO representative on options for home modifications, DME, assistive technology, or other adaptive equipment. * Assists clinical team with the recommendations for equipment and services as needed. Collaborate with the support team to report observations and outcomes. * Document all member encounters per documentation standards. Minimum Requirements: * Requires graduate of a college level program in physical therapy, occupational therapy, or an accredited two-year program for a Physical Therapist Assistant or Occupational Therapist Assistant and minimum of 2 years' experience in social service or health care field; or any combination of education and experience, which would provide an equivalent background. * Current active, valid and unrestricted license or certification as a physical therapist assistant or occupational therapist assistant in applicable state required. Certification and/or licensure appropriate to field of specialty as required. * Bilingual Korean Required. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

LTSS Concierge Coordinator (Case Manager) Hiring statewide across Ohio This position is primarily virtual but may require you to work in the field based on business need up to 10% of the time. Location: 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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The MyCare Ohio health plan is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The LTSS Transition Concierge Coordinator is responsible for supporting the LTSS Transition Coordinator (or contracted provider) in contributing to the components of the person-centered planning process, within Transitions of Care, for individuals enrolled in specialized programs, as required by applicable state law and contract, and federal requirements. Supports in the development, monitoring, and assessment of changes during any transitions of care into the Service Coordination forms and tools, such as the individual's Person-Centered Support Plan (PCSP) in accordance with member's needs. Supports individuals in meeting their established goals, in the setting of their choice, and accessing quality health care services and supports. How you will make an impact: * Responsible for performing telephonic and/or virtual outreach to individuals in specialized programs, providers, or other key stakeholders to support the efficacy of the care plan and/or to align with contractual requirements for member outreach, such as coordination and management of an individual's LTSS waiver, behavioral health or physical health needs. * Responsible for in-person visits, as needed, to accommodate business need. * Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual's care plan. * Utilizes tools and pre-defined identification process, consults with the primary service coordinator to monitor the PCSP, in instances in which a risk is identified related to the members LTSS, physical or behavioral health supports (including, but not limited to, potential for high-risk complications). * Engages the primary service coordinator and other clinical healthcare management and interdisciplinary teams to provide care coordination support. * Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of long-term services and supports. * At the direction of the member, documents their short- and long-term service and support goals in collaboration with the member's chosen care team that may include, caregivers, family, natural supports, and physicians. * Identifies members that would benefit from an alternative level of service or other waiver programs. * May also serve as mentor, subject matter expert or preceptor for new staff, assisting in formal training of associates and may be involved in process improvement initiatives. * Responsible for reporting critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement). * Assists and participates in appeal or fair hearings, member grievances, appeals and state audits. Minimum Requirements: * Requires BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * Strong computer skills to include Excel, Outlook and Electronic Medical Records highly preferred. * BA/BS degree field of study in health care related field preferred. * Strong preference for case management experience with older adults or individuals with disabilities. * Specific education, years, and type of experience may be required based upon state law and contract requirements preferred. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Audit & Reimbursement III Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: * Analyzes and interprets data and makes recommendations for change based on judgment and experience. * Able to work independently on assignments and under minimal guidance from the manager. * Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. * Gain experience with applicable Federal Laws, regulations, policies and audit procedures. * Respond timely and accurately to customer inquiries. * Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills. * Must be able to perform all duties of lower-level positions as directed by management. * Participates in special projects and review of work done by auditors as assigned. * Assist in mentoring less experienced associates as assigned. Job specific functions for Reopening Team: * Review Medicare cost report re-openings initiated from provider requests, CMS requests, or by the MAC * Perform level 1 or level 2 audit review as part of the reopening process on all areas of the Medicare cost report such as Medicare DSH, Bad Debts, IME/DGME, NAH, Organ Acquisition and all cost based principles * Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records * Actively participate in development of Audit & Reimbursement standard operating procedures * Activity participate in workgroup initiatives to enhance quality, efficiency and training Minimum Requirements: * Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background. * This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities and Experiences: * Degree in Accounting or Finance preferred. * Knowledge of CMS program regulations and cost report format preferred. * Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred. * MBA, CPA or CIA preferred. * Must obtain Continuing Education Training requirements (where required). * A valid driver's license and the ability to travel may be required. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $61,560 to $102,060 Locations: Maryland, Minnesota, Nevada, and New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The PBM Pricing Strategy Analyst Manager is responsible for Pharmacy Services pricing and Administrative Services Only (ASO) support functions. How You Will Make an Impact Primary duties may include, but are not limited to: * Implements new processes, process improvements, and best practices related to pricing, guarantee monitoring, and ASO pass back activities. * Creates and implements metrics and supports performance measures to establish performance objectives for revenue maximization and pharmacy pricing. * Creates tools and processes to monitor margin revenue, pricing accuracy, and client retention. * Monitors revenue performing below thresholds and implements necessary tasks to bring performance to or above targets. * Implements pricing in the system related to margin. * Supports the Pharmacy Services team in implementing future revenue, member expansion and growth capacity. * Assists with developing pharmacy pricing training to underwriters and updates to underwriting guidelines. Minimum Requirements: Requires a BA/BS in Finance or related field and a minimum of 5 years of experience with a Pharmacy Benefits Manager (PBM), pricing, data analysis; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: MBA strongly preferred. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

LTSS Service Coordinator - RN Clinician (Case Manager) Hiring statewide across Ohio Location: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. The MyCare Ohio health plan is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The LTSS Service Coordinator-RN Clinician is responsible for overall management of member's case within the scope of licensure, develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of prioritizing person-centered thinking and optimizing member health care across the care continuum. How you will make an impact: * Responsible for performing telephonic and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports. Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team. * Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. * Obtains a thorough and accurate member history to develop an individual care plan. * Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs. * The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services. * May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible. * Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans. May also assist in problem solving with providers, claims or service issues. Minimum Requirements: * Requires a high school diploma or GED equivalent and minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background. * Current, active valid and unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and Experiences: * BA/BS in Health/Nursing preferred. * Strong preference for case management experience with older adults or individuals with disabilities. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Medical Management Specialist I Location: Washington, DC. This role requires associates to be in-office 4 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of remote work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: Monday-Friday 8:00AM-5:00PM or 8:30AM-5:30PM EST The Medical Management Specialist I will be responsible for providing non-clinical support to the Medical Management and/or Operations areas. How you will make an impact: * Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review). * Provides information regarding network providers or general program information when requested. * May assist with complex cases. * May act as liaison between Medical Management and/or Operations and internal departments. * Maintains and updates tracking databases. * Prepares reports and documents all actions. * Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. Minimum Requirements: * Requires a H.S. diploma or equivalent and a minimum of 1 year experience or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities & Experiences: * Understanding of managed care or Medicaid/Medicare strongly preferred. For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $23.46/hr - $35.19/hr. Locations: District of Columbia (Washington, DC) In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Assistant Director, Volunteer Advocacy and Community Mobilizations REPORTS TO: Director, Volunteer Advocacy and Community Mobilization SUPERVISION EXCERCISED: None ABOUT THE ORGANIZATION: ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism and battling bigotry wherever and whenever it happens, ADL works to protect democracy and ensure a just and inclusive society for all. PRIMARY FUNCTION: This position is an integral member of the Volunteer Advocacy and Community Mobilizations team within the National Affairs department. The Assistant Director of Volunteer Advocacy and Community Mobilizations will share responsibility for facilitating and coordinating a robust community engagement strategy for ADL, with a particular focus on building relationships with volunteer leaders and community partners. This person will be responsible for designing, implementing, and tracking strategies that mobilize people to advocate and volunteer to further ADL's mission and policy priorities. Responsibilities Primary: Support and help lead the implementation of grassroots and grasstops advocacy campaigns; Grow ADL's base of volunteer support and collaborate on the creation of a network of ambassadors and messengers to represent ADL; Oversee the training and coordination of our volunteers, equipping them with the skills and knowledge needed to effectively advocate for ADL's policy priorities; Create and support the development of materials, toolkits, and resources for volunteer advocates; Own, develop and maintain a system to track and analyze the impact of volunteer- led advocacy campaigns, leveraging data to support strategy refinement; Support digital efforts to mobilize the ADL community and its allies in support of policy efforts, including digital activations like Calls to Action, social media campaigns, etc. Secondary: Provide logistical support for the Volunteer Advocacy and Community Mobilizations team; Become the ambassador for empowering volunteers to other departments and colleagues at ADL; Drive and support the execution/mobilization efforts of the ADL federal and state lobby days; Provide ongoing reports on programming impact; Manage interns as needed on community engagement projects. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: Excellent communication skills and ability to engage with community leaders; Commitment to advancing transparency and accountability in addressing antisemitism; Able to support and execute multiple projects; Creative problem solver with entrepreneurial spirit and self-starting nature; Results-oriented with a sense of urgency; Team player with willingness to play multiple positions as needed; Technology skills including expertise with EveryAction/NGP/VAN and visual storytelling and experience with AI tools; Strong organizational and project coordination skills. High tolerance for ambiguity Attributes: Committed to contributing to a culture where everyone thrives Collaborative team-player. Creative and innovative; takes initiative. Results-oriented - a problem solver (versus a problem identifier) Excels in dynamic environments that require adaptability Ability to manage multiple priorities simultaneously Work Experience: The ideal candidate has several years' experience in electoral work, volunteer management, social impact design, project management, community organizing or other related areas required. Demonstrable experience supporting advocacy campaigns and volunteer mobilization efforts preferred Work Environment: ADL is a hybrid environment; this role may require 3 days in the office. Flexibility is required to work extended hours or on weekends as needed. Occasional travel is required to attend meetings, events and conferences. Compensation: This position has a salary range of $70,000 to $80,000. This salary range is reflective of a position based in New York, NY. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.

The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. Program Consultant - Ohio MyCare Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. This role is based in Ohio with positions located in either the Columbus, Cincinnati, Mason, or Seven Hills area. Must be available to travel to different office locations as needed. Ohio residency is a requirement for this position. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: This position will work an 8-hour from shift 8:00 am - 5:00 pm (EDT) Monday to Friday. Additional hours, including weekends or holidays, may be required based on operational needs. The Program Consultant is responsible for the development and ongoing management of one or more external client facing programs within a business unit. Program consultants typically support business strategies through an integrated portfolio of external client facing projects or initiatives. How You Will Make an Impact Primary duties may include, but are not limited to: * Manages the development, approval, implementation and compliance of on-going external client facing programs. * Ensures program meets its stated objectives and provides subject matter expertise in response to day-to-day business issues. * Researches applicable subject matter practices and remains aware of industry trends. * Maintains external business partner profiles by managing relationships with corporate and regional partners. * Coordinates training related to the external client facing program, develops program success measures and performs periodic assessments of external client facing program. * Supports partners in performing readiness assessments when new services are rolled out or when existing services are expanded or enhanced. * Works with the delegated agencies to drive transformation , policies, audit and provide day to day supports to ensure compliance. Minimum Requirements: * Requires a BA/BS in a related field and minimum of 3 years experience in external client facing program management; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: * Lived experiences with behavioral health and HCBS waiver service programs is strongly preferred. * Experience with relationship building, training and compliance preferred. * Field or project management experience preferred. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Location: This role requires associates to be in-office 1 - 2 days per week at one of our four Ohio offices (Cincinnati, Columbus, Mason, Seven Hills) fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered for employment, unless an accommodation is granted as required by law. The Compliance Manager is responsible for managing foundational and strategic compliance responsibilities with consistent excellence that support the team and management. How You Will Make an Impact * Manage/oversee projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing audit preparedness. * Establish project plans, gap analysis, milestone dates, and other significant aspects, and leadership updates. * Maintain knowledge of laws, regulations, company strategies to assess impact, and consult with clients as subject matter expert. * Conducts complex investigations, document findings, and ensure corrective actions are made. * Interface with external clients, regulators, vendors, supplier; internal stakeholders, high level of management. Minimum Requirements * Requires a BA/BS and minimum of 6 years health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences * Experience with Medicaid, Medicare or Dual Special Needs Plans highly preferred. * Ability to travel may be required. * MS/MBA/JD or professional designation preferred. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Be Part of an Extraordinary Team The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. Network Relations Consultant Senior (Value-Based Program Specialist) - MyCare Ohio Location: This position is based in Ohio; the associate will report to one of our 4 office locations below: * 3075 Vandercar Way, Cincinnati, OH 45209 * 8940 Lyra Drive, STE 300, Columbus, OH 43240 * 4361 Irwin Simpson Road, Mason, OH 45040 * 6000 Lombardo Center, STE 200, Seven Hills, OH 44131 In Office Expectation: Hybrid 1; This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Shift & Hours: Monday-Friday, 8:00 AM - 5:00 PM Eastern Time The Network Relations Consultant Senior (Value-Based Program Specialist) is responsible for and is fully dedicated to delivering on the LTSS commitment to linking provider payment to improved performance. This role will support the design and modification of Anthem VBP, based on stakeholder feedback and utilization. How You Will Make an Impact Primary duties may include, but are not limited to: * This associate will partner with Ohio Department of Medicaid (ODM), other LTSS contractors, and stakeholders to support the deployment of Value Based Payment methodologies for home and community-based services and long-term care nursing facility services, as well as to providers of other covered services, to meet provider needs and drive quality * In addition to advising on innovative programming for Anthem and supporting the VBPs, the role will be responsible for provider training, technical assistance, utilization, and performance monitoring related to the VBP offerings. * Work collaboratively with stake holders to define key VBP performance indicators and deliver accurate and timely program performance to the providers as defined by program-specific requirements. * Establish a core set of measures to be included in all provider feedback reports, standardized across all LTSS Contractors issuing the feedback reports. * May be responsible for coordinating negotiated contracts for new and existing providers as needed. * Functions as a high-level technical resource to resolve or facilitate complex provider issues. * Coordinates Joint Operation Committees (JOC) of larger provider groups, driving the meetings in the discussion of issues and changes. * Identifies and reports on provider utilization patterns which have a direct impact on quality-of-service delivery. * Tracks and conduct provider refresher training as needed. * Researches issues that may impact future provider negotiations or jeopardize network retention. * Travels to worksite and other locations, as necessary. Minimum Requirements: * Requires a Bachelor's degree and a minimum of 5 years of customer service experience including 2 years' experience as a Network Management Representative; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, & Experiences: * Prior experience as an LTSS or HCBS provider or in a provider office is preferred. * Experience training or mentoring preferred. * Value Based contracting/payment concepts experience preferred. * Provider education experience preferred. * Experience presenting to various levels of leadership strongly preferred. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. Medical Management Clinician Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. This position will be based at any Pulse Point available in Ohio, US Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: This position will work an 8-hour from shift 8:00 am - 5:00 pm (EDT) Monday to Friday. Additional hours may be necessary based on company needs. The Medical Management Clinician responsible for ensuring appropriate, consistent administration of plan benefits by reviewing clinical information and assessing medical necessity under relevant guidelines and/or medical policies. May collaborate with healthcare providers. Focuses on moderately complex case types that do not require the training or skill of a registered nurse. How you will make an impact. Primary duties may include, but are not limited to: * Responsible for moderately complex cases that may require evaluation of multiple variables against guidelines when procedures are not clear. * Work may be facilitated, in part, by algorithmic or automated processes. * Handles moderately complex benefit plans and/or contracts. * Works on reviews that may require guidance by more senior colleagues and/or management. * May serve as a resource to less experienced staff. * Conducts and may approve precertification, concurrent, retrospective, out-of-network, and/or appropriateness of treatment setting reviews by assessing clinical information against appropriate medical policies, clinical guidelines, and the relevant benefit plan/contract. * May process a medical necessity denial determination made by a Medical Director. * May work directly with healthcare providers to obtain and understand clinical information. * Refers complex or unclear reviews to higher level nurses and/or Medical Directors. * May educate members about plan benefits and physicians. Does not issue medical necessity non-certifications. Minimum Requirements: * Requires H.S. diploma or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. * Current active, valid and unrestricted LPN/LVN license or RN license and/or certification to practice as a health professional within the scope of licensure in applicable state(s) or territory of the United States required. * Multi-state licensure is required if this individual is providing services in multiple states. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Provider Contract/Cost of Care Consultant Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future VISA sponsorship. The Provider Contract/Cost of Care Consultant provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues. Works on large scale initiatives with high dollar cost savings opportunities. Partners with provider contractors to develop contracting strategy and supports all aspects of the contract negotiation process. Can work with multiple provider types, e.g. physician, ancillary, medical groups, or hospitals. Supports a full range of contract arrangements and pricing mechanisms. Works on complex enterprise-wide initiatives and acts as project lead. How you will make an Impact: * Uses analytic tools to track both health risks and compliance, as well as supporting the contract negotiation process. * Types of analyses include performing sophisticated retrospective data analytics; building new and modifying existing complex models to create predictive impact decision making tools; performing healthcare cost analysis to identify strategies to control costs; projecting cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis; preparing pre-negotiation analysis to support development of defensible pricing strategies; performing modeling to compare various contract scenarios based on member utilization patterns and 'what if' logic; measuring and evaluating the cost impact of various negotiation; researching the financial profitability/stability and competitive environment of providers to determine impact of proposed rates; and projects different cost of savings targets based upon various analytics. * Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures. * Recommends policy changes and claim's system changes to pursue cost savings. * Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable. * Recommends standardized practices to optimize cost of care. * Educates provider contractors on contracting analytics from a financial impact perspective. * May recommend alternative contract language and may go on-site to provider premises during contract negotiations. * Participates on project team involved with enterprise wide initiatives. * Acts as a source of direction, training and guidance for less experienced staff. Minimum Requirements: Requires BS/BA degree in Mathematics, Statistics, or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: * Healthcare Industry highly preferred. * High proficiency in SQL * Data analytics within healthcare industry * Exposure to Python or R * Master's degree preferred. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Director II Medical Cost Intelligence AI & Engineering (Dir II Engineering) Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidate resides within a commutable distance from an office. The Director II Medical Cost Intelligence AI & Engineering is responsible for strategic oversight and delivery of enterprise technology solutions, inclusive of AI, analytics and agentic solutions, business units and enterprise functions focused on managing medical cost. Delivery responsibilities will include leading engineering teams and collaborating with internal technology teams to deliver scalable enterprise level solutions that will proactively manage medical costs through the use of AI & analytics focused capabilities to drive affordable healthcare across the industry. The role will also be responsible for drive innovation technology solutions that change the strategic landscape of how Elevance Health manages medical costs and proactively identifies and takes actions to ensure affordable healthcare. How you will make an impact: * Planning, directing, and controlling multiple teams of resources and initiatives to accomplish the objectives and requirements defined by senior technology and product management across multiple teams. This is inclusive of design, development, and testing teams delivering AI & analytics solutions. * Provides technology thought leadership to business partners ensuring teams are delivering scalable solutions that enable enterprise level priorities and financial goals. * Responsible for the planning and execution of technology solutions and the ability to manage to budgetary constraints. * Interfaces with key technology solution vendors; develops strategies and facilitates performance measurement plans to optimize vendor and associate performance and outcomes. * Develops application technology plans, forecasting for an enterprise application, enterprise-wide tool, infrastructure, or a center or domain that is equivalent in scope and complexity. * Manages a domain or suite of applications (or the equivalent capital and/or level of responsibility). * Oversees strategic planning, budget development, and management for a single large or multiple cost centers, contract compliance, and any necessary integration of government regulatory requirements. * Ensures disaster recovery and business continuity plan are implemented, monitored, and updated on a recurring basis. * Ensures delivery and supports system solutions that support the continuous operations. * Identifies and resolves hurdles for assigned areas/groups according to established deadlines. * Establishes and maintains collaborative relationships with key business partners. * Partners with customers in order to understand new product enhancements or features being requested. * Plans and executes annual projects while maintaining profit and loss (P&L) responsibility. * Establishes and maintains collaborative relationships with key business partners. * Hires, trains, coaches, counsels, and evaluates performance of direct reports. Minimum Requirements: Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 8 years of IT management experience in the area of function being managed; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: * Health insurance industry experience, specifically at a provider or payer strongly preferred. * AI delivery of business solutions strongly preferred. * Experience delivering AI and technology solutions for a targeted business function strongly preferred. * Prior people leadership experience preferred. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. Please Note: If this is not a straight backfill, please consult with your HR Business Partner prior to posting/using this job. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $199,936 to $327,168. Locations: California, District of Columbia (Washington DC), Illinois, New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Location : Candidate must reside in the state of Ohio. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Possible travel within the state of Ohio when needed. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Housing Outreach Specialist is responsible for developing and implementing the health plans housing strategy and programs. This includes the approach to assisting individuals in programs in securing accessible, affordable housing through Federal and local programs. The Specialist will possess knowledge of housing programs and services, focusing on homelessness and at-risk populations, and specific accessibility needs as related to LTSS populations. How you will make an impact : * Liaise between housing agencies and the health plan and partner with these agencies to develop and access affordable housing services for members. * Partner with the Health Plan trainers to develop and implement training specific to affordable housing services in the state of Ohio. * Work under the Housing First model, honoring Member choice. * Responsible for working with housing agencies and other housing programs to help develop and access affordable housing services for Members receiving LTSS. * Responsible for education and supporting Care Coordinators and Support Coordinators in identifying housing options for members. Minimum Requirements : * Requires a minimum of 3 years experience in developing housing and/or housing policy at a local, state or federal level for special populations such as the elderly, people with disability and/or people with mental health challenges to secure accessible, affordable housing through Federal and local programs; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities & Experiences : * Bachelor's degree in Social Services or related field highly preferred. * Case management experience with older adults or individuals with disabilities. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Pay rate ranges from $17.00 to $17.00 based on experience. At Lifeline Vascular Care, we provide the highest quality, most comprehensive and up-to-date care for our patients. Our employees are talented, passionate health care professionals who know how to provide excellent patient care and customer service. We look for people who have a strong work ethic with a positive outlook and team-work attitude with the skills to match. We are seeking a qualified Registered Nurse for immediate placement in our Vascular Access Center, located in Columbus, OH. The ideal candidate will have 2 years experience in general diagnostic, and special procedures, cardiac catheterization; experience in IR and Cath Lab is a plus. The Registered Nurse will gather pre-treatment patient data, monitor patient and medications during procedures, maintain prescription drug logs and provide assistance to the clinical team during pre and post procedure activities. This is a challenging, fast-pace job with Monday to Friday schedule, NO nights and weekend shifts. Access Center hours Monday Friday, 7 am to 4 pm. Our employees enjoy a great work/life balance and a highly supportive team environment. We offer competitive pay commensurate with experience and an excellent benefits package including the following: Health, Dental and Vision Insurance Basic Life and Disability Insurance Whole Life, Group Accident and Hospital Indemnity Flexible Spending Account or HSA available 401(k) with Employer match Paid Holidays and a generous Paid Time Off Plan Employment at Lifeline Vascular Care is contingent on successful completion of pre-employment screening and background check. Responsibilities and Duties: Provides ongoing patient information to the interventionist and clinical team during procedures to deliver vascular access care to the patient including but not limited to cardiac monitoring, aldrete score, pain status. Monitor patient vitals (HR, BP, O2Sat, EKG) during procedures. Assist in recovery room patient care following vascular access procedures. Gather patient clinical information prior to procedures including patient assessments and patient history. Maintain up-to-date narcotic drug log. Maintain clear and accurate patient medical records. Communicate with dialysis facilities to monitor post-care as directed by center manager. Participate in access center community education programs. Monitor and maintain adequate inventory of medical supplies. Assist in scheduling patients for vascular access procedures and provide assistance in transporting patients within the center. Participate in community education activities regarding the Access Center. Experience: Registered Nurse: 2 years (Preferred) Scrub: 1 year (Preferred) Lifeline provides equal employment opportunities (EEO) to all employees and applicants for employment regardless of race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Lifeline Vascular Care complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Please submit resume on our online application site. Requirements: 2 years RN experience preferably in dialysis, critical care, medical/surgical or ambulatory surgery Current RN license in state of practice Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) Associate's or Bachelors degree in Nursing Basic computer skills and proficiency in MS Word and Outlook Works with others in a cooperative and supportive manner Displays patience and compassion in all patient interaction

JR167272 Manager Behavioral Health Services Responsible for overseeing Behavioral Health Utilization Management (BH UM), this position supports the Medicaid line of business. Location: Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. How will you make an impact: * Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures. * Ensures staff adheres to accreditation guidelines. * Supports quality improvement activities. * May assist with implementation of cost of care initiatives. * May attend meetings to review UM and/or CM process and discusses facility issues. * Hires, trains, coaches, counsels, and evaluates performance of direct reports. * Responsibilities for BH UM may include: Manages a team of licensed clinicians and non-clinical support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services; ensures appropriate utilization of BH services through level of care determination, accurate interpretation/application of benefits, corporate medical policy and cost efficient, high quality care; manages consultation with facilities and providers to discuss plan benefits and alternative services; manages case consultation and education to customers and internal staff for efficient utilization of BH services; leads development and maintenance of positive relationship with providers and works to ensure quality outcomes and cost effective care; assists in developing clinical guidelines and medical policies used in performing medical necessity reviews; provides leadership in the development of new pilots and initiatives to improve care or lower cost of care. Minimum requirements: LICENSURE REQUIREMENTS FOR ALL FUNCTIONS: * Requires current, active, unrestricted license such as LCSW (as applicable by state law and scope of practice), LMHC, LPC, LMSW (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States. * For Government business only: LAPC, and LAMFT are also acceptable if allowed by applicable state laws and any other state or federal requirements that may apply; provided that the manager's director has one of the types of licensures specified in the preceding sentence. * Licensure is a requirement for this position. EDUCATION/EXPERIENCE REQUIREMENTS: * Prior experience in Managed Care setting required. * Additional requirements for BH UM: MS in social work, counseling, psychology or related behavioral health field or a degree in nursing and minimum of 5 years of clinical experience with facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of education and experience, which would provide an equivalent background. * Experience applying clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred. Preferred Skills, Capabilities, and Experiences: * Leadership and prior management experience. * Experience in managed care. * Candidates from all states are welcome, but they must reside within commuting distance of a Pulse Point office location where we have an office to be considered. * Proficiency in MS Office and data reporting. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement Senior will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A reimbursement. This position provides a valuable opportunity to gain advanced experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: * Evaluate the work performed by other associates to ensure accurate reimbursement to providers. * Assist Audit and Reimbursement Leads and Managers in training, and development of other associates. * Participates in special projects as assigned. * Able to work independently on assignments and under minimal guidance from the manager. * Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. * Analyze and interpret data with recommendations based on judgment and experience. * Must be able to perform all duties of lower-level positions as directed by management. * Participate in development and maintenance of Audit & Reimbursement standard operating procedures. * Participate in workgroup initiatives to enhance quality, efficiency, and training. * Participate in all team meetings, staff meetings, and training sessions. * Assist in mentoring less experienced associates as assigned. * Prepare and perform supervisory review of cost report desk reviews and audits. * Review of complex exception requests and CMS change requests. * Perform supervisory review of workload involving complex areas of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing and Allied Health, Organ Acquisition, Wage Index and all cost based principles. Minimum Qualifications: * Requires a BA/BS and a minimum of 8 years of audit/reimbursement or related Medicare experience; or any combination of education and experience which would provide an equivalent background. * This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Qualifications: * Accounting degree preferred. * Knowledge of CMS program regulations and cost report format preferred. * Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred. * Must obtain Continuing Education Training requirements. * MBA, CPA, CIA or CFE preferred. * Demonstrated leadership experience preferred. * A valid driver's license and the ability to travel may be required. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $ 73,720 to $122,220 Locations: Maryland, Minnesota, Nevada and New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Policy Counsel REPORTS TO: VP, Policy Counsel SUPERVISION EXERCISED: None GRADE/CLASS: Grade H, Exempt, PSA-eligible ABOUT THE ORGANIZATION ADL is the leading anti-hate organization in the world. Founded in 1913, its timeless mission is “to stop the defamation of the Jewish people and to secure justice and fair treatment to all.” Today, ADL continues to fight all forms of antisemitism and bias, using innovation and partnerships to drive impact. A global leader in combating antisemitism, countering extremism, and battling bigotry wherever and whenever it happens, ADL works to ensure a just and inclusive society for all. PRIMARY FUNCTION The Policy Counsel will play a central role in shaping and implementing ADL's local, state and national legislative and policy agenda using evidence-based legal approaches and tactics. As a legal, legislative, and policy subject matter expert on ADL's national advocacy priorities, the Policy Counsel will work in close coordination with external experts and ADL's national and regional teams to ensure that the policy and advocacy approaches ADL supports are legally sound, effective, and impactful. Responsibilities Primary: Lead the development and implementation of legal and policy strategies in pursuit of ADL policy priorities, consistent with ADL research. Monitor and analyze federal and state legislative, regulatory, and judicial developments that affect the safety of the Jewish community. Partner with ADL's national and regional teams, including COE, CAR, the federal affairs team, the state and local advocacy team, regional offices, the litigation team, and other experts to provide real-time policy responses to incidents and trends. Draft legislation, regulations, memoranda, position papers, public comments, and advocacy materials. Collaborate with national security, law enforcement, and civil society partners to shape effective, constitutionally informed responses to threats. Serve as a spokesperson or expert representative in public fora, during legislative briefings, and through media engagements as appropriate. This provides a general overview of the role and its key responsibilities. It is not an exhaustive list of all duties, and ADL reserves the right to assign additional tasks as needed. Qualifications Skills: Exceptional legal research, analysis, and writing skills. Strong public speaking and coalition-building capabilities. Attributes: Passionate about ADL's mission and driven to combat antisemitism in all forms. Open-minded and solutions-oriented with the ability to understand diverse perspectives. Strategic thinker and effective advocate who can build consensus and advance complex policy goals. Entrepreneurial mindset with the ability to lead initiatives and respond to emerging challenges. Collaborative, strategic, and responsive under pressure. Work Experience: Demonstrated experience in policy, litigation, or advocacy roles. Government, nonprofit, or legislative experience preferred but not required. Experience with online harm, content moderation, and/or technology regulation is highly desirable. Education: J.D. degree required. Work Environment: Flexibility to work extended hours and travel occasionally as required. Must be able to engage in prolonged computer and desk work. Willingness to travel to regional offices, national convenings, or public events, including some weekends. ADL is a hybrid environment; this role may require 3 days in the office. Compensation: This position has a salary range of $90,000 to $125,000. This salary range is reflective of a position based in Dallas, Texas. Please note that actual salaries are commensurate with experience and reflect the budget for a given position, and since ADL has a location-based compensation structure, there may be a different range for candidates in other locations. For an overview of our total rewards package, please visit ********************************** ADL aims to create a working environment where every employee can thrive professionally. Our mission-driven work is best accomplished in an environment that supports belonging. ADL values a diverse workplace and strongly encourages people of all races, religions, nationalities, genders, LGBTQ+ individuals, people with disabilities, and veterans to apply. ADL is an equal opportunity employer. Recruitment, hiring, promotions and other terms, conditions and privileges of employment shall be maintained in a manner which does not discriminate on the basis of age, race, creed, religion, color, national origin, sex, sexual orientation, gender expression, marital status, physical or mental disability, veteran status, or military status, or in violation of any applicable Federal, state or local laws. ADL will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. For individuals with disabilities who would like to request an accommodation to support the interview process, please contact the People & Culture department at ************************* . ADL will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the Fair Credit Reporting Act, and all other applicable State, Local, and Federal laws. The information in this job description indicates the general nature and level of work expected of employees in this classification. It is not designed to contain, or be interpreted as, a comprehensive inventory of all duties, responsibilities, qualifications and objectives required of employees assigned to this job, nor is it to be interpreted as a contract for employment.

Medical Director -Long Term Support and Services Preferred Location: Ohio. Please note that per our policy this role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The Medical Director -Long Term Support and Services is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. How will you make an impact: * Oversee all primary and physical health services provided to individuals of the health plan, including those receiving LTSS, ensuring the appropriate level of medical care is received. Identifies potential issues, project change, and scope data. * Ensure services align with LTSS clinical and service coordination requirements as defined by state and federal contracts/rules. * Conduct targeted LTSS Case Management training sessions, emphasizing the most prevalent medical diagnoses affecting the key LTSS populations. * Assist with resource development and drive Health Plan collaborations to support LTSS/HCBS populations. * 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. Minimum Requirements: * Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). * Must possess an active unrestricted medical license to practice medicine or a health profession. Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. * A minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * For Health Solutions and Carelon organizations (including behavioral health) only, a minimum of 5 years of experience providing health care is required. * * Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency.* Preferred Skills, Capabilities and Experiences: * Minimum of ten years of clinical experience, including at least five years of experience directing healthcare services for target populations strongly preferred. * 1-2 years Utilization Management experience strongly preferred. * Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. 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. 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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.