Initiative Project Leader - Payment Integrity Unified Ecosystem

Initiative Project Leader - Payment Integrity Unified Ecosystem Location: This role requires associates to be in-office 3 days per week , fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidatesresidewithin a commuting distance from an office, with ideal candidates being able and willing to work Eastern or Central Time Zone business hours. 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 Unified Ecosystem 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 lead the PI Unified Ecosystem initiative by coordinating business and technology partners and driving the development of new Payment Integrity solutions and applications. How You Will Make an Impact 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 supporting the PI Unified Ecosystem through integration points in Claims, Health Plans, Operations, PE&C, PSCCR, Finance, Actuary, Digital, and IT. Leads the PI Unified Ecosystem from assessment through implementation, developing actionable project plans and ensuring business controls are in place to monitor sustainable results. Builds consensus across business and technology workstreams, leads root cause analysis, uncovers trends, contributes to solution definition, and determines internal and external best practices. Establishes and manages program milestones, dependencies, risks, decisions, and recovery plans to keep the development of new Payment Integrity solutions and applications moving forward. Uses data-supported reporting to communicate program health, identify delivery gaps, and provide objective red, yellow, and green status updates. Articulates initiative drivers, investment value, anticipated return, progress, risks, and results through compelling communications tailored to executive, business, and technical audiences. Creates and maintains an end-to-end PI Unified Ecosystem roadmap that enables informed prioritization, cross-functional alignment, and delivery against major transformation milestones. Minimum Requirements: 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. Preferred Skills, Capabilities, & Experiences: Payment Integrity, healthcare payer, claims, cost-of-care, healthcare technology, or related healthcare operations experience preferred. Proven experience leading large-scale, multiyear enterprise transformation initiatives involving business, product, operations, digital, and technology partners preferred. Strong project leadership experience, including developing project plans, establishing milestones, managing dependencies and risks, and driving cross-functional work through implementation preferred. Demonstrated ability to navigate ambiguity, independently determine next steps, solve complex problems, and move initiatives forward with limited direction preferred. Strong business, systems, data, and digital fluency, including the ability to analyze information, identify trends, evaluate opportunities, and translate findings into actionable recommendations preferred. Exceptional executive communication and storytelling skills, including experience developing compelling business cases, presentations, and value or return-on-investment narratives preferred. Proven ability to build trusted relationships, influence without direct authority, and drive alignment and accountability across highly matrixed organizations preferred. Experience developing strategic roadmaps and working within Agile, product-development, or technology-transformation environments using tools such as Aha!, Jira, or Smartsheet preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $136,800.00 to $235,980.00. Locations: California; Columbus, OH; Connecticut; Illinois; Maryland; Massachusetts; Nevada; New Jersey; New York; Virginia; and Washington State. 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, paid time off, stock, 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. 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 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 . #J-18808-Ljbffr