Fraud Investigator

Anticipated End Date: 2026-09-05 Position Title: Business Change Director - SIU Fraud and Abuse (AI) Business Change Director - SIU Fraud and Abuse (AI) 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 candidates reside within a commuting distance from an office, with ideal candidates being willing to work Eastern 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. Business Change Director - SIU Fraud and Abuse is responsible for supporting the AI Portfolio by driving short-term and long-term AI strategy, implementation, adoption, and value realization. This role partners with business, product, digital, and technology leaders to identify, prioritize, and execute initiatives that advance business unit and enterprise AI objectives. How you will make an impact Primary duties may include, but are not limited to: Collaborate with business stakeholders and product/digital teams to gather, analyze, and document business and technical requirements for AI and technology initiatives, ensuring alignment with strategic goals and measurable outcomes. Maintain open communication between business and technology teams, ensuring AI priorities, dependencies, timelines, risks, and adoption challenges are effectively communicated to stakeholders. Facilitate solution development by translating business needs into technical requirements and identifying opportunities to improve business processes through AI-enabled capabilities and automation. Identify potential risks, project changes, and scope impacts, and lead efforts to establish best practices, governance, and cross-functional process integration. Conduct cost-benefit and value realization analyses for AI initiatives, design scalable processes, and operating models, and build organizational support for business transformation. Provide project, process, and change management coaching and consulting support for AI and digital transformation initiatives, including prioritization and roadmap planning activities. Define, monitor, and report on key performance indicators (KPIs), adoption metrics, and business outcomes to evaluate AI initiative effectiveness and drive continuous improvement. Partner with leadership to ensure AI initiatives align with enterprise strategy, governance standards, regulatory requirements, and responsible AI practices. Minimum Requirements Requires a BA/BS in a related field and a minimum of 10 years of experience managing mid-to-large-scale business transformation, change management, or project initiatives; or any combination of education and experience that would provide an equivalent background. Preferred Skills, Capabilities, and Experience Master's degree preferred. Experience with AI, digital transformation, business process optimization, financial planning models, data analytics, project management, and change management methodologies strongly preferred. Experience applying Six Sigma methodologies, particularly process improvement, problem-solving, and statistical analysis (DMAIC); Six Sigma Black Belt highly preferred. Exceptional strategic thinking, decision-making, problem-solving, and adaptability skills highly preferred. Experience interacting confidently with senior leadership and executive stakeholders, serving as a trusted advisor, and influencing strategic decision-making preferred. Excellent written, verbal, presentation, and interpersonal communication skills, with a demonstrated ability to align and negotiate priorities across multiple stakeholder groups strongly preferred. Proficiency with Microsoft Excel, Teams, Outlook, PowerPoint, and Word strongly preferred. Familiarity with AI governance, responsible AI principles, AI adoption frameworks, and measurement of AI business outcomes preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $115,360.00 to $207,648.00. *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. Job Level: Director Equivalent Job Family: BSP > Business Support 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 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. #J-18808-Ljbffr