Job Description:
Location: Elevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection. This includes remote work and 1-2 days in office per week. Candidates must reside within a 50-mile or 1-hour commute each way of an Elevance Health PulsePoint location.
Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
Manager I Claims is responsible for providing oversight for Medicare claims operations staff, leading approximately 30 associates.
How you will make an impact:
- Establishes departmental policies and procedures.
- Provides quality control services by monitoring work results of direct reports.
- Performs audits to monitor efficiency and compliance with policies.
- Monitoring and maintaining claims and adjustment inventories to achieve performance metrics.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Requirements:
Requires BA/BS and a minimum of 1 year of experience in a leadership role and 2 years related experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
- Claims and rework knowledge
- Managed care business knowledge
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.
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