Pharmacy Benefits Manager (PBM) Pricing Strategy Analyst, Senior
Carebridge job in Columbus, OH
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, Senior is responsible for 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 guarantee monitoring and ASO pass back activities.
* Creates and implements metrics and supports performance measures to establish performance objectives for revenue maximization.
* Creates tools and processes to monitor margin revenue 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.
Minimum Requirements:
Requires a BA/BS in Finance or related field and a minimum of 3 years of experience with Pharmacy Benefits Manager (PBM), data analysis; or any combination of education and experience, which would provide an equivalent background.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $86,064 to $129,096
Locations: Minnesota
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.
Auto-ApplyDirector II Medical Cost Intelligence AI & Engineering
Carebridge job in Columbus, OH
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.
Auto-ApplyPerformance Quality Analyst II
Carebridge job in Independence, OH
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.
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 Performance Quality Analyst II is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.
How you will make an impact:
* Assists higher level auditor/lead on field work as assigned and acts as auditor in charge on small and less complex audits.
* Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment & billing transactions and the corrective action plan process.
* Demonstrates ability to audit multiple lines of business, multiple functions, and multiple systems.
* Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks.
* Works closely with the business to provide consultation and advice to management related to policy and procedure identified as out of date or incomplete and investigates, develops and recommends process improvements and solutions.
* Functions as a subject matter expert for discrepancy review, questions from team and business partners, and interpretation of guidelines and audit process.
* Acts as a mentor to peer auditors, providing training and managing work and projects as necessary.
Minimum Requirements:
Requires a BS/BA; a minimum of 3 years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1 year related experience in a quality audit capacity; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* WGS Claims processing experience strongly preferred.
* Experience/knowledge with local claim processing.
* Understanding of individual member benefits and cost shares preferred.
* Understanding of small, large and national group benefits and cost shares preferred.
* Prefer contract language.
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.
Auto-ApplyProvider Contract Specialist Manager
Carebridge job in Columbus, OH
Carelon Behavioral Health Location: 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.
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
The Provider Contract Specialist Manager functions with the expertise in managing negotiated pricing loads. Responsible for coordinating the process for the most complex pricing arrangements involving facilities or large health systems, or high profile provider groups and/or physician groups tied to large hospital systems joining the network including creating standard contracts for providers as needed.
How you will make an impact:
* Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery system.
* Prepare the information for timely and accurate submission to the Provider Data Management area.
* Ensure updates/changes for existing network providers are interpreted and loaded accurately.
* Ensure accurate and timely loading of professional and facility contracts across value based and fee for service agreements for provider solutions.
* Works directly with contracting directors and managers to understand what is negotiated and how the negotiated agreement is translated into the company's systems resulting in accurate and timely loading.
* Performs internal audit of provider record, ensuring accuracy against rosters.
* Serves as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround.
* Serve as local market expert supporting (and managing when necessary) the provider onboarding process and provider updates submitted by provider offices within defined market.
* Must possess critical thinking skills, have a proven strong eye for detail and a focus on quality.
Minimum Requirements:
* Requires a H.S. diploma or equivalent and a minimum of 5 years of experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background
Preferred Skills, Capabilities and Experiences:
* Centralized Data Management: Use a centralized system or database to manage and store provider and system data. This improves data consistency and accessibility.
* Automated Updates: Implement automated processes for updating provider information, such as credentials, specialties, and contact details, to minimize manual errors.
* Data Standardization: Ensure that data is entered in a standardized format across all systems. This includes using consistent naming conventions, codes, and classifications.
* Enrollment System: Manages the enrollment of providers into insurance plans, ensuring they meet all necessary requirements and regulatory guidelines followed.
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.
Auto-ApplyLicensed Journeyman Electrician
Ohio City, OH job
Description Triad Associates Inc., a division of Concordia Group, is a privately held full-service engineering and telecom infrastructure construction firm experiencing rapid growth across the country. Clients consider us the ‘best choice' for their design and construction needs. We are one of the very few engineering firms in the country that designs and builds its own creations in the wireless sector. We support Fortune 500 clients such as T-Mobile, Verizon, US Cellular, Dish Network, and AT&T. We offer competitive compensation and robust benefits including BCBS health care, dental, vision, PTO and sick leave plans, company vehicle with gas card, generous per diem when traveling, PLUS an overly generous 401K program (what can we say, we LOVE our employees)! Come join in our success! Pay Range: $30.00 - $42.00 / hour
Factors, such as but not limited to, geographical location, relevant experience, education, and skill level may impact the pay for this position
Responsibilities:
Please note: this role requires extensive travel. Road warriors welcome!
Install and repair electrical equipment on cell phone towers
Work closely with construction crews and Project Managers to meet deadlines
Perform routine maintenance on electrical wiring and systems
Be responsible for the electrical installation that meets client standards for the quality of work, with an emphasis on meeting the budgeted hours available.
Be knowledgeable of all aspects of electrical construction materials and control equipment that make up the field installation part of a cell tower site
Interprets drawings, sketches, software, plans and determines best work procedures, tools, equipment needed to troubleshoot and repair problems
Inspect cell tower sites for compliance with plans and specifications, point out deficiencies, coach and take corrective action as needed.
Provides training, direction, and mentorship to our Electrical Apprentice/Construction Crews.
Promote safety on the jobsite in connection with the installation and service work.
Measures, cuts, bends, threads, assembles and installs electrical conduit; weld supports; install cable and duct banks; make terminations
Qualifications:
Be a licensed Journeyman Electrician in the desired state
Experience in the construction industry, telecom industry experience is a plus
Ability to work in a team environment with construction crews, Project Managers, and Foremen
Work in all weather conditions
Have a valid Driver's License
Triad Associates Inc. is a division of Concordia Group. Triad Associates Inc. is a drug and alcohol free workplace including marijuana. Triad Associates Inc is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Auto-ApplyUtilization Management Representative II (Virtual in Ohio)
Carebridge job in Independence, OH
Utilization Management Representative II Schedule: Monday-Friday 8am-5pm Eastern Time Must be located in the state of Ohio 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
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.
How you will make an impact:
* Responsible for managing incoming calls, including triage, opening of cases and authorizing sessions.
* Primary duties may include, but are not limited to: Managing incoming calls or incoming post services claims work.
* Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
* Obtains intake (demographic) information from caller.
* Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given.
* Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care.
* Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization.
* Verifies benefits and/or eligibility information.
* May act as liaison between Medical Management and internal departments.
* Responds to telephone and written inquiries from clients, providers and in-house departments.
* Conducts clinical screening process.
Minimum Requirements:
* Requires high school diploma or GED equivalent and a minimum of 2 years customer service experience in healthcare related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* Experience with LTSS support or waivers strongly preferred.
* Health plan knowledge (prior authorizations experience) strongly preferred.
* Flexibility and strong attention to detail preferred.
* For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills 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.
Auto-ApplyHousing Modification Specialist
Carebridge job in Independence, OH
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.
Work Schedule : Monday - Friday 8am - 5pm EST
The Housing Modification Specialist is responsible for developing and implementing the health plans home modification strategy and program. This includes the approach to assisting individuals in the HCBS Waiver in receiving modifications to their home to allow them to have greater access to their home environment (i.e. wheelchair accessible ramp, accessible shower, widening of doorways, etc.).
How you will make an impact :
* Collaborate with home modification providers and internal health plan stakeholders to ensure an efficient process for members accessing home modifications.
* Partner with MyCare lead trainers to develop and implement training specific to home modifications in Ohio.
* Support Care Coordinators and Support Coordinators in identifying home modification needs and ensuring an efficient process.
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:
* Certified Aging in Place Specialist (CAPS) preferred or commitment to obtain certification within one year of employment.
* Strong preference for case management experience with older adults or individuals with disabilities.
* BA/BS in Health/Nursing 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.
Auto-ApplyAI Machine Learning Scientist
Carebridge job in Mason, OH
Location: Atlanta, GA; Richmond, VA; Indianapolis, IN; Mason, OH; Chicago, IL (preferred). 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.
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 AI Machine Learning Scientist is responsible for Artificial Intelligence (AI) scientific and statistical methods to assist with product creation, development and improvement.
How you will make an impact:
* Develops and maintains infrastructure systems that connect internal data sets.
* Creates new data collection frameworks for structured and unstructured data.
* Leads enterprise-scale AI initiatives by designing horizontal capabilities such as RAG, evaluations-as-a-service, prompt/version control, guardrails, feature, and vector stores, adopted across business units.
* Develops, analyzes, and models complex operational, clinical, and economic data, while delivering end-to-end ML systems (XGBoost / LightGBM) and LLM systems with clear SLOs.
* Architects scalable solutions including cloud lakehouse (Databricks / Spark, SQL), streaming (Kafka/Kinesis), and API-first approaches; oversees serving technologies (vLLM / Triton / KServe / Ray / SageMaker).
* Establishes and manages LLMOps / MLOps processes using tools like MLflow, CI/CD, and IaC, focusing on observability, drift detection, hallucination rates, and maintaining SLOs/SLAs.
* Implements data leadership strategies that include data contracts, quality SLAs, and FHIR-aware design for PHI/PII, with a focus on embedding/vectorization strategies.
* Develops Responsible AI frameworks including fairness/robustness evaluations, red-teaming, and model risk management, ensuring audit readiness (HIPAA, SOC 2, HITRUST).
* Defines visions and OKRs for strategy and portfolio management, orchestrating build-buy-partner decisions and optimizing ROI and FinOps, while influencing VP/C-suite and ensuring cross-functional alignment.
* Mentors principal and lead contributors, drives design reviews, and oversees Agile/SAFe delivery across multiple teams.
* Demonstrates proven outcomes by shipping AI products with measurable clinical and business impact.
* Develop experimental and analytic plans for machine learning algorithms and data modeling processes
* Use of strong baselines.
* Determines cause and effect relations.
Minimum Requirements:
* Requires a Bachelor's degree in a highly quantitative field (Computer Science, Machine Learning, Operational Research, Statistics, Mathematics, etc.) or equivalent degree and 4 or more years of experience; or any combination of education and experience in configuration management, which would provide an equivalent background.
Preferred Skills, Capabilities & Experiences:
* Prefer Master's or PhD. degrees in a quantitative field (or equivalent) and 6+ years of experience in building production ML/LLM systems, with leadership in multi-team programs.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $138,160 to $207,240
Locations: Chicago, IL
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.
Auto-ApplyPharmacy Technician I - Medication Access Specialist
Carebridge job in Mason, OH
Be Part of an Extraordinary Team Carelon Health is a proud member of the Elevance Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.
Build the Possibilities. Make an Extraordinary Impact.
Title: Pharmacy Technician I - Medication Access Specialist
Location(s): Mason, OH, Indianapolis, IN, Seattle, WA, Atlanta, GA, Miami, FL, Richmond, VA, Las Vegas, NV, Houston, TX
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. 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.
As a Pharmacy Technician I - Medication Access Specialist, you will be responsible for the interpretation and data entry of basic prescriptions, handling medication access issues, and troubleshooting adjudication concerns. This role emphasizes problem-solving, communication, and member advocacy.
How you will make an impact:
* Member Support: Serve as the primary contact for members experiencing medication access issues, providing empathetic and knowledgeable assistance.
* Troubleshooting and Prior Authorization: Identify and resolve barriers to medication access, including insurance pre-authorizations and formulary restrictions. Process prior authorization requests from healthcare providers to ensure compliance with Medicare requirements, and inform relevant parties of determinations.
* Collaboration: Work closely with healthcare providers, insurance companies, and pharmacies to resolve complex medication access cases.
* Education and Communication: Inform members about pharmacy-based rules, alternative medications, and resources for assistance programs. Navigate members through the appeals process when necessary.
* Documentation and Reporting: Accurately document member interactions and generate reports relating to rebates, physician utilization, and other relevant metrics. Maintain records of prior authorizations and monthly reports.
* Continuous Improvement: Suggest process enhancements to improve the member experience by identifying patterns in medication access barriers.
Minimum Requirements:
* Requires H.S. diploma or equivalent and minimum of 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
* Current State Pharmacy Tech.
* Certification or National Certification based on applicable state(s) required.
Preferred Skills/Experience/Education:
* CPhT, certified pharmacy technician strongly preferred.
* Experience with Medicaid members strongly preferred.
* Retail pharmacy experience strongly preferred.
* Strong understanding of insurance billing processes and formulary management strongly preferred.
* Problem solving skills preferred.
* Excellent verbal/written communication skills preferred.
* Ability to work independently highly preferred.
* Flexibility highly preferred.
* Compassionate approach to patient care with a strong commitment to service excellence highly preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
If his job is used in Simply Healthcare or Americas First Choice, no UM approval or denial activities will be performed by the associate.
For candidates working in person or virtually in the below location(s), the hourly salary* range for this specific position is $16.92-$29.19.
Location(s): Washington, Nevada
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.
Auto-ApplyGroup Underwriter Consultant
Carebridge job in Cincinnati, OH
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.
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 Group Underwriter Consultant will be responsible for determining acceptability of insurance risks and appropriate premium rates for large and complex group cases. Position is a technical underwriting expert.
How you will make an impact:
* Calculates renewal rates for large complex cases based on thorough analysis of experience, location, demographics, etc.
* Determines and provides guidance to medical underwriters concerning the risk selection of applicants applying for individual health coverage.
* Coordinates with other departments to ensure accuracy and consistency of overall account reporting.
* Proposes rates for prospective business utilizing a combination of other carrier experience, demographic data and manual rates.
* Performs post-sale reviews.
* Prepares or supervises preparation of annual settlements, ERISA reports, rate projections, or benefit change increments and decrements.
* Surveys existing product portfolios by market, monitors sales results, trends and needs, recommends product portfolio changes.
* Assists in establishing rating and administrative procedures.
* Participates in major multi-functional teams as underwriting representative.
* Assists in the technical development of underwriting associates, which may include monitoring reports and work flow to provide recommendations on productivity and efficiency improvements.
* Updates and monitors departmental processes and procedures in compliance with system, regulatory and business requirements.
Minimum Requirements:
Requires a BA/BS in a related field; Minimum 5 years of related experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
* Intermediate Microsoft Excel experience to include advanced proficiency in formulas, PivotTables, VLOOKUPs, and macros is strongly preferred.
* CPCU, CLU, LOMA, HIAA or other insurance related courses preferred.
* Healthcare industry experience preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $83,200 to $143,520.
Locations: California, Colorado, Illinois, Washington
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.
Auto-ApplyBusiness Information Consultant- Health System Reimbursement
Carebridge job in Mason, OH
Location: This role requires associates to be in-office 1 day 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. Ideal candidates will be able to report to one of our Pulse Point locations in Atlanta, GA, Richmond, VA, Indianapolis, IN, Wallingford, CT or Mason, OH. 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.
The Business Information Consultant- Health System Reimbursement is responsible for serving as an expert in data analysis, reporting and formulating recommendations and providing guidance to other data analysts.
How you will make an impact:
* Establishes, improves, and optimizes the consolidating processes for forecast and month-end results.
* Consolidates and prepares executive summary reports for various business segments in the SBU for top management decision-making.
* Analyzes and designs solutions to address varied and highly complex business needs.
* Collaborates with businesses and technical areas to implement new or enhanced products.
* Coordinates with external audits as appropriate.
* Acts as the central contact with internal departments and external auditors.
* Creates and maintains databases to track business performance.
* Analyzes data and summarizes performance using summary statistical procedures.
* Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.
* Creates and publishes periodic reports, as well as any necessary ad hoc reports.
* Makes recommendations based upon data analysis.
* Provides analytic consultation to other business areas, leadership or external customers.
* Data analysis and reporting encompasses a much higher level of complexity.
Minimum Requirements:
Requires a BS/BA degree in related field and a minimum of 5 years of experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* Proficient in modeling the financial impacts of changes in reimbursement structures and rates for health systems such as hospitals and physician practices highly preferred.
* Experience benchmarking hospital or physician rates against Medicare reimbursement highly preferred.
* Excel, SQL, and SAS experience highly preferred.
* Strong knowledge of products as well as our internal business models and data systems highly preferred.
* Experience providing leadership in evaluating financial performance of complex organizations highly preferred.
* Excellent leadership, problem solving, organizational, planning, presentation and interpersonal skills highly preferred.
* Ability to work independently and draw up plans to address issues/concerns highly 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.
Auto-ApplyBehavioral Health EAP Consultant II
Carebridge job in Cincinnati, OH
Shift: Sunday - Wednesday 6:00pm - 4:30am EST 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
The Behavioral Health EAP Consultant II is responsible for providing 24/7 Behavioral Health and Employee Assistance services to up to approximately 10 million lives.
How you will make an impact:
* Supports Employee Assistance Program (EAP) service department by responding to initial customer contacts and request for services; receives client request, assesses situation, determines appropriate course of action.
* Provides telephone and/or on-site support for crisis intervention, assessment, short term problem resolution and referral to appropriate provider(s).
* Manages Critical Incident Stress Debriefing requests.
* Assesses members and assists them in accessing behavioral healthcare benefits available under their health plan.
* Applies specialized knowledge in substance abuse, domestic abuse, grief counseling, workplace problems, and management consultation.
* Provides employer consultation to supervisors, managers, and Human Resources of the EAP contracted organization.
* Manages shared mailbox that is used by clients and external vendor to forward information that must be reviewed and placed in documentation system.
Minimum Requirements:
* Requires a HS diploma or equivalent and a minimum of 5 years of direct psychiatric and/or substance abuse experience and prior managed care experience; or any combination of education and experience, which would provide an equivalent background.
* Current unrestricted license such as (but not limited to) LPC (as allowed by applicable state laws), LCSW, LMSW, LMFT, LMHC, or Licensed Professional Counselor, in applicable state(s) required.
Preferred skills, capabilities, and experiences:
* MA/MS 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.
Auto-ApplyClinical Pharmacist, Population Health
Carebridge job in Seven Hills, OH
Be Part of an Extraordinary Team CarelonRx is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our strong, clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry.
Build the Possibilities. Make an Extraordinary Impact.
Title: Clinical Pharmacist, Population Health
Location(s): Mason, OH, Cincinnati, OH, Seven Hills, OH, Columbus, OH
Hybrid: 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.
The Clinical Pharmacist, Population Health is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS, and formulary management. This role also involves providing pharmacy support to Medicare, Commercial, and Medicaid providers, focusing on improving quality (STAR and HEDIS) and cost measures. You will work closely with providers engaged in value-based care, influencing prescribing practices to improve members' health and reduce the total cost of care.
How you will make an impact:
* Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.
* Evaluate pharmacy quality program data and work with stakeholders to identify, prioritize, and implement strategies to optimize medication use and manage pharmacy spending effectively.
* During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements.
* Work to improve pharmacy quality by staying up to date on STAR and HEDIS measures.
* Provider education to support clinical pharmacy measures and reduce pharmacy costs.
* Build impactful relationships with providers to close the feedback loop between pharmacy and provider.
Minimum Requirements:
* Requires BA/BS in Pharmacy.
* Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.
* Requires a registered pharmacist.
* Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
* For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position.
Preferred Skills, Capabilities, and Experiences:
* PharmD preferred.
* Experience with Medicaid programs, particularly in Ohio preferred.
* Microsoft Excel experience strongly preferred.
* PBM or managed care experience strongly preferred.
* Passionate about building relationships with external provider partners to improve member health preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have 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.
Auto-ApplyRisk, Controls, and Assurance Intern - 2026
Carebridge job in Mason, OH
Location: Indianapolis, IN or Mason, OH. 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.
An RCA Intern will be responsible for supporting our Risk, Controls, and Assurance team in ensuring the stability and compliance of internal controls over financial reporting and audit/regulatory compliance obligations. Key regulations and standards supported by these efforts include Generally Accepted Accounting Principles (GAAP), Sarbanes-Oxley (SOX), statutory Model Audit Rule (MAR), and System and Organization Controls 1 (SOC1) reporting.
This internship will be a full-time (40 hours/week) program that will run for 8-11 months with two cohorts, one starting in January 2026 and the other May 2026.
How you will make an impact:
* Create and document results of control testing and review.
* Provide research support, develop work programs, engagement plans and collaborate with audit team members.
* Assess risk of financial processes, operational processes, and the supporting IT systems.
* Document business processes dependent on financial data systems.
* Analyze results of specific or general work requests.
* Having direct contact with external audit firms for purposes of audit planning and remediation
* Opportunity to do innovative work that means more to you and those we serve
* Create greater care for our members, greater value for our customers, and greater health for our communities
Minimum Requirements:
* The ability to work 40 hours per week for the duration of the internship and work in-office at least once per week.
* Actively pursuing a Bachelor's or Master's degree in either: Accounting, Finance, Business Information Systems, Management Information Systems, or a related program (MSA, MBA, MSIS, etc).
Preferred Skills, Capabilities, and Experiences:
* Excellent Problem-solving, Analytical, and Organizational skills
* Excellent written and verbal communication skills
* Excellent organization and time management skills
* Ability to work in a team-based team environment
* Skilled in Microsoft Office Suite with emphasis on Excel, Word, and Access
* Excellent Communication skills, both written and oral
* Excellent Problem-solving, Analytical, and Organizational skills
* Excellent Public Speaking and Presentation 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.
Auto-ApplyBusiness Information Consultant Senior
Carebridge job in Mason, OH
Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. The Business Information Consultant Senior is responsible for coordinating and consolidating various impact analyses for management reporting.
How you will make an impact:
* Establishes, improves, and optimizes the consolidating processes for forecast and month-end results.
* Consolidates and prepares executive summary reports for various business segments in the SBU for top management decision-making.
* Analyzes and designs solutions to address varied and highly complex business needs.
* May collaborate with businesses and technical areas to implement new or enhanced products.
* May require strong knowledge of products as well as our internal business models and data systems.
* May coordinate with external audits as appropriate.
* Acts as the central contact with internal departments and external auditors.
Minimum Requirements:
Requires a BA/BS degree in Statistics, Economics, or Business Administration and minimum of 8 years of relevant experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
* Experience providing leadership in evaluating financial performance of complex organizations strongly preferred.
* Excellent leadership, problem solving, organizational, planning, presentation and interpersonal skills strongly preferred.
* Ability to work independently and draw up plans to address issues/concerns 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.
Auto-ApplyAI Application Architect Senior
Carebridge job in Mason, OH
Location: This role requires associates to be in-office 1 day 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. Ideal candidates will be able to report to one of our Pulse Point locations in Atlanta, GA, Hanover, MD, Mason, OH, Indianapolis, IN, Ashburn, VA, Norfolk, VA or New York, NY. 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.
The AI Application Architect Senior creates architectural solutions that articulate the business context, conceptual design, and component-level logical design.
How you will make an impact:
* Recommends new technologies based upon business value drivers and return on investment.
* Drives new technologies towards implementation and exploitation.
* Establishes overall systems architecture vision and ensures specific components are appropriately designed and leveraged.
* Contributes to the holistic vision of Enterprise Architecture.
* Defines architecture standards and anticipate areas where architecture standards may need to be developed that are in-line with customer, IT and industry standards.
* Directs the construction of architecture components (e.g., data architecture, application architecture, technical architecture).
* Works with business units to translate business strategy into discrete requirements compatible with current technical architectures.
* Defines systems, technical, and application architectures for new strategic initiatives.
* Develops and maintains an architectural blueprint and evolutionary roadmap that defines and communicates the strategic direction for these architectures in support of business and technical strategies.
* Explains how the roadmap maintains and delivers cost effectiveness, business value, and competitiveness.
Minimum Requirements:
Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 5 years of experience in architecture/design in relevant technology disciplines; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
* AI experience highly preferred.
* Data architect experience highly preferred.
* Cloud experience highly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $131,880 to $226,080.
Locations: Hanover, MD, New York, NY
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.
Auto-ApplyTelephonic Nurse Case Manager II
Carebridge job in Cincinnati, OH
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.
Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST.
* This position will service members in different states; therefore, Multi-State Licensure will be required.
This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria.
The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically.
How you will make an impact:
* Ensures member access to services appropriate to their health needs.
* Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
* Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
* Coordinates internal and external resources to meet identified needs.
* Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
* Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
* Negotiates rates of reimbursement, as applicable.
* Assists in problem solving with providers, claims or service issues.
* Assists with development of utilization/care management policies and procedures.
Minimum Requirements:
* Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
* Current, unrestricted RN license in applicable state required.
* Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Capabilities, Skills and Experiences:
* Case Management experience.
* Certification as a Case Manager.
* Minimum 2 years' experience in acute care setting.
* Managed Care experience.
* Ability to talk and type at the same time.
* Demonstrate critical thinking skills when interacting with members.
* Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
* Ability to manage, review and respond to emails/instant messages in a timely fashion.
For candidates working in person or virtually in the below locations, the salary* range for this specific position is $76,944 to $126.408.
Locations: Colorado; New York; New Jersey
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.
Auto-ApplyHealth Promotion Manager
Carebridge job in Cincinnati, OH
Location: This role requires associates to be in our Cincinnati, OH, Indianapolis, IN, Louisville, KY or Chicago, IL 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.
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.
Hours: Monday - Friday 8:00am to 4:30pm or 8:30am to 5:00pm EST.
The Health Promotion Manager is responsible for consulting and leveraging health promotion and healthy lifestyle behaviors for employers, consultants and consumers to win new business, retain accounts and grow membership in all lines of business.
How you will make an impact:
* Develops multi-year health promotion plans and engagement strategies.
* Conducts customer worksite wellness assessments.
* Designs customized health promotion solutions leveraging capabilities as market-place differentiators with the employer and consultant communities.
* Optimizes the use of wellness dollars to promote member engagement and position wellness as a competitive differentiator with clients.
* Designs and trains the Sales team on how to market and implement innovative health promotion solutions and best practices.
Minimum Requirements:
* Requires an BA/BS degree in Health Education, Public Health or related field and a minimum of 6 years' experience; or any combination of education and experience which would provide and equivalent background.
Preferred Capabilities, Skills and Experiences:
* MS/MA degree preferred.
* Registered Nurse, Certified Health Education Specialist, Registered Dietician, or Exercise Physiologist preferred.
* Ability to monitor medical utilization data for trends, analyze geographic health statistics, disease prevalence, and program engagement.
For candidates working in person or virtually in the below locations, the salary* range for this specific position is $89,936 to $134,904.
Locations: Illinois
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.
Auto-ApplyBehavioral Health EAP Consultant II
Carebridge job in Cincinnati, OH
Shift: Friday - Monday 5:00pm - 3:30am EST 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
The Behavioral Health EAP Consultant II is responsible for providing 24/7 Behavioral Health and Employee Assistance services to up to approximately 10 million lives.
How you will make an impact:
* Supports Employee Assistance Program (EAP) service department by responding to initial customer contacts and request for services; receives client request, assesses situation, determines appropriate course of action.
* Provides telephone and/or on-site support for crisis intervention, assessment, short term problem resolution and referral to appropriate provider(s).
* Manages Critical Incident Stress Debriefing requests.
* Assesses members and assists them in accessing behavioral healthcare benefits available under their health plan.
* Applies specialized knowledge in substance abuse, domestic abuse, grief counseling, workplace problems, and management consultation.
* Provides employer consultation to supervisors, managers, and Human Resources of the EAP contracted organization.
* Manages shared mailbox that is used by clients and external vendor to forward information that must be reviewed and placed in documentation system.
Minimum Requirements:
* Requires a HS diploma or equivalent and a minimum of 5 years of direct psychiatric and/or substance abuse experience and prior managed care experience; or any combination of education and experience, which would provide an equivalent background.
* Current unrestricted license such as (but not limited to) LPC (as allowed by applicable state laws), LCSW, LMSW, LMFT, LMHC, or Licensed Professional Counselor, in applicable state(s) required.
Preferred skills, capabilities, and experiences:
* MA/MS 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.
Auto-ApplyCompliance Consultant Senior
Carebridge job in Cincinnati, OH
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 Consultant Senior is responsible for delivering and executing foundational and strategic compliance responsibilities with consistent excellence that support the team and management at the most senior advanced level.
How You Will Make an Impact
* At the most senior advanced level, report, communicate, research laws, regulations, requirements, regulatory audits and/or exams.
* Provide senior level analytical support to projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments.
* Utilize systems unique to job functions, including standard-issue software such as Microsoft products; maintain system documentation, serve as subject matter expert, train users of system, contribute to system design, oversight or maintenance.
* Apply critical thinking to formulate strategies and concepts that drive results, persuade and influence others, adapt to change, and manage conflict.
Minimum Requirements
Requires a BA/BS and minimum of 5 years health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background.
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.
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