Initiative Project Leader - Payment Integrity Product

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 Initiative Project Leader - Payment Integrity Product is responsible for analyzing, determining and driving opportunities to standardize, eliminate waste and improve end-to-end processes to transform Payment Integrity solutions that will enable value and improve member, end-user, and provider experience.

This Leader will strengthen operating strategy, roadmap visibility, organizational communications, and alignment across Payment Integrity and its enterprise partners.

Primary duties may include, but are not limited to:

• Serves as a thought leader regarding improvements to end-to-end processes with our providers, members, and internal end-users in mind.
• Connects critical dots across matrixed organizations and the broader Payment Integrity portfolio through integration points in Claims, Health Plans, Operations, PE&C, PSCCR, Finance, Actuary, Digital, and IT.
• Leads strategic initiatives from assessment through implementation and ensures business controls are in place to monitor the sustainability of process improvements.
• Builds consensus across organizational functional areas, leads root cause analysis, uncovers trends, contributes to solution definition, and determines internal and external best practices.
• Creates greater visibility into organizational priorities, budgets, capacity plans, release schedules, risks, and dependencies to support leadership decision-making.
• Plans and manages the organization’s rhythm of business, including leadership reviews, State of the State meetings, all-hands meetings, newsletters, release notes, and follow-up actions.
• Articulates strategic priorities, roadmap status, risks, decisions, and results through clear communications tailored to executive, operational, and technical audiences.
• Creates and maintains an end-to-end Payment Integrity roadmap that enables leadership to prioritize, rebalance resources, and keep shared organizations focused on the highest-value work.

Requires a BA/BS degree in a related field and a minimum of 8 years of professional experience in an operations environment including 7 years of leading and directing large enterprise-wide projects; or any combination of education and experience, which would provide an equivalent background.

• Experience serving in a chief of staff, executive business partner, enterprise strategy, business operations, portfolio management, or transformation leadership capacity preferred.
• Exceptional executive communication and storytelling skills, including the ability to translate complex information into clear presentations, transformation updates, get to the “so what” and value proposition, release management, prioritization and leadership communications preferred.
• Experience developing and managing enterprise roadmaps, organizational priorities, capacity plans, budgets, release schedules, and executive-level status reporting preferred.
• Demonstrated ability to operate as a highly accountable and detail-oriented self-starter who can navigate ambiguity, identify gaps, and independently drive work to completion preferred.
• Ability to build trusted relationships, influence without direct authority, and coordinate priorities across highly matrixed business, operations, product, digital, finance, and technology organizations preferred.
• Strong business, systems, data, and digital fluency, including the ability to analyze information, identify trends, assess risks, and develop actionable recommendations preferred.
• Experience planning and managing leadership rhythms of business, including operating reviews, organizational meetings, strategic planning activities, and follow-up actions preferred.
• Payment Integrity, healthcare payer, claims, cost-of-care, healthcare technology, or other complex regulated enterprise experience preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

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.

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. 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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.