Solutions Management Director

Position Title:

Solutions Management Director

Job Description:

Solutions Management Director

Location: This position will work on a hybrid model (office and remote). The ideal candidate will live within 50 miles of our Chicago or Atlanta PulsePoint locations. Some travel required up to 20%.

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology, and oncology.

The Solutions Management Director is responsible for leading the planning and implementation of Carelon Medical Benefits Management products, driving greater connectivity with provider groups and health plans to modernize prior authorization workflow and drive efficiencies through the use of artificial intelligence. This role will be responsible for the Digital Solution roadmap, serving as the subject matter expert for external connections, data exchanges, and technical acumen.

How you will make an impact:

• Lead efforts to support post-acute solution EHR integrations and facilitate API connections.
• Support and drive artificial intelligence initiatives, inclusive of operational adoption of automation tools.
• Drive planning sessions with appropriate stakeholders e.g., (vendors, architects, and products).
• Document requirements, maintain interface agreements, and support testing prior to planned go-lives.
• Work closely with product teams to ensure alignment between the business case and integration requirements.
• Provides business partners with the resources, training, and services necessary to effectively utilize the products that provides.
• Provides consultation and advice to business partners regarding the benefits of products and analytics.
• Schedules and coordinates implementation of contracted products and services for assigned business partners.
• Coordinates data requirements, production schedules, and deliverables with the business partner.
• Oversees all business partner specifications and/or modifications for contracted products and services.
• Analyzes business partner data for QA and identification of opportunities for business partners to utilize products and services to improve plan performance.
• Maintains expert knowledge of current clinical measures and future clinical measure development plans, communicates this information to business partners, assists in the selection of clinical measures to be utilized in the pilot and full rollout of products and services, and guides business partners in continually reviewing and updating clinical measure sets.
• Maintains expert knowledge of all current systems, products, and services and a basic understanding of the future system and product development plans to allow an appropriate level of communication with business partners.
• Supports business strategies through an integrated portfolio of programs, projects, and initiatives.

Minimum Requirements:

• Requires a BA/BS and minimum of 8 years experience in a related field, including minimum of 3 years Solutions Management experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications, Skills, and Experiences:

• Graduate degree and/or professional designation related to field preferred.
• Prior project experience with electronic health record integrations (e.g., Epic, Homecare Homebase).
• Deep understanding of interoperability requirements.
• Strong technical acumen is preferred.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $111,920 to $201,456.

Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, 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.

Job Level:

Director Equivalent

Workshift:

Job Family:

BSP > Business Support

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Elevance Health approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World's Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.