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　　Manager of Program Mgmt, Clinical Audit

　　Job Family: Business Support

　　Type: Full time

　　Date Posted:Jan 16, 2024

　　Anticipated End Date:Mar 13, 2024

　　Reference: JR101270

　　Location:

　　OH, MASON

　　FL, MIAMI

　　NJ, MORRISTOWN

　　GA, ATLANTA

　　IN, INDIANAPOLIS

　　OH, CINCINNATI

　　KY, LOUISVILLE

　　NY, NEW YORK

　　NH, MANCHESTER

　　TX, GRAND PRAIRIE

　　VA, RICHMOND

　　NY, MIDDLETOWN

　　LA, METAIRIE

　　MN, GILBERT

　　DC, WASHINGTON

　　MN, MENDOTA HEIGHTS

　　VA, NORFOLK

　　CT, WALLINGFORD

　　MO, ST LOUIS

　　NC, CARY

　　MD, HANOVER

　　WV, CHARLESTON

　　NJ, ISELIN

　　OH, SEVEN HILLS

　　IL, CHICAGO

　　RI, SMITHFIELD

　　ME, SOUTH PORTLAND

　　NC, WINSTON

　　GA, ATLANTA

　　NY, LATHAM

　　OH, COLUMBUS

　　TX, HOUSTON

　　VA, ROANOKE

　　MA, WOBURN

　　FL, TAMPA

　　Description

　　Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.

　　Our Complex and Clinical Audit Organization is looking to hire a Manager of Program & Project Management for our Implant Audit Team. The People Leader will be responsible for ensuring the overall success of multiple, cross-functional implant audit programs and projects through a team of Implant Nurse Auditors. Programs may include planning, process improvement, change management, quality/tracking initiatives, staffing, contract reviews, and implementations. This position can work from any US Elevance Health corporate work location in a hybrid way 1 day per week, preferably residing in the EST or CST time zone as this team works on EST cadence.

　　How you will make an impact:

　　Successfully manage a team of coding and/or clinical auditors.

　　Develop, research, and implement clinical and/or coding auditing concepts.

　　Plans implant program/project scope and design. Facilitates determination of required deliverables and validation of ROI.

　　Establishes process to continually monitor program progress.

　　Develop metrics and program/project reporting tools.

　　Analyze variance to program/project plan.

　　Lead building of documentation to support business objectives and ensure consistency.

　　Responsible for championing local stakeholders and tactical decision-makers. Hires, trains, coaches, counsels, and evaluates performance of direct reports.

　　Requires a BA/BS and minimum of 5 years experience in project/program management, process reengineering, organizational design, and/or implementation; or any combination of education and experience, which would provide an equivalent background.

　　Preferred skills and experiences:

　　-Background in Nursing with medical implant or prosthetics experiences (or medical surgical domains such as Orthopedics or Cardiac)

　　-ICD9 and CPT Coding certification preferred.

　　-Experience managing people is highly preferred.

　　-Clinical Audit experience in the payment integrity domain

　　For candidates working in person or remotely in the below locations, the salary* range for this specific position is $110,160 to $198,288

　　Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

　　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. 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 [email protected] for assistance.

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　　Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.

　　EEO Policy Statement

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　　Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)

　　Need Assistance?

　　Email us ([email protected])