Manager special audit

Job Family: BSP > Program/Project

Type: Full time

Date Posted: Jun 10, 2024

Anticipated End Date: Jul 05, 2024

Reference: JR119219

Description

Location: Indianapolis, IN, Tampa FL, Grand Prairie TX, Nashville TN, Richmond VA

Hours: M – F Standard Working hours

Travel: Hybrid (1-2 days onsite per week)

Position Overview:

The Manager II of GBD Special Programs is responsible for management and oversight of multi state program operations and will support the overall strategic approach of the LTSS Center of Excellence. The position is responsible for the development, implementation, and coordination of comprehensive provider auditing for effective oversight, monitoring, and quality improvement of LTSS service providers and vendors.

How You Will Make an Impact:

• Directs and oversees program operations in support of corporate and health plan management specific to provider auditing functions and fiscal intermediary oversight.

• Directs and collaborates with functional managers to develop and implement the steps necessary to manage program operations across all LTSS markets.

• Implements provider auditing and oversight practices in new LTSS markets.

• Leads policy/process development and ensuring adherence to contractual and federal requirements specific to LTSS providers in collaboration with necessary teams.

• Participates in cross-functional workgroups created to maintain and develop program.

• Evaluates program operations to improve efficiency of operations, financial return, customer service, and provider engagement.

• Develops, communicates, and monitors program schedule, budget, and resources plan.

• Manages resource utilization to ensure appropriate delivery of care to members and adequate coverage for departmental tasks and job responsibilities.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Required Qualifications:

• Requires a BA/BS and minimum of 6 years’ experience, including prior management experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Experience in self-directed Healthcare programs

• Experience in Healthcare provider auditing strongly preferred

• Project management experience preferred

• Data analytics experience preferred

• Change management experience is a plus

• Experience leading a team 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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 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 assistance.