Anticipated End Date:
2026-11-20
Position Title:
Business Change Director - Carelon Payment Integrity
Job Description:
Business Change Director – Carelon Payment Integrity
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.
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.
Carelon , a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center—connecting physical, behavioral, social, and pharmacy services, along with clinical expertise, research, operations, and advanced technology to help care work better, together.
Among us are care providers, engineers, data scientists, and other dedicated professionals determined to recover, eliminate and prevent unnecessary medical-expense spending.
The Business Change Director will be responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals.
How you will make an impact:
May specialize in one area of organization effectiveness (planning, project portfolio, or culture/change) or be assigned to directly support a business unit and ensures activities are aligned with corporate strategy.
Identifies potential issues, project change, and scope data.
Leads efforts to identify best practices.
Identifies impacted parties, business partners, and resources required.
Develops and designs processes and systems that support business needs.
Designs methods for integrating functions and processes.
Conducts cost/benefit analyses.
Builds support for business change throughout the business unit.
Provides process, project, and change management methodology coaching/consulting support to both local and enterprise wide initiatives.
Leads the project prioritization and scheduling activities for the business unit.
Provides expertise to the business areas in culture/change management activities.
Provides expertise in process planning and portfolio management activities.
Supports the execution of the operating plan.
Minimum Requirements:
Requires a BA/BS in a related field and minimum of 10 years managing mid to large-scale change/project initiatives; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Knowledge of planning models and methodology, project management and change management experience (strategic and execution) strongly preferred.
Masters degree preferred.
Six Sigma Black Belt preferred.
3-5 years of experience in Payment Integrity is strongly preferred.
Experience in payment integrity: Data mining, recoveries, cost of care, or financial project management is highly desired.
Experience in successfully developing and managing projects with significant. operating budgets and knowledge of process redesign is strongly preferred.
Project management experience desired.
Experience with claims processing systems, such as GBD Facets and/or WGS highly desired.
Experience facilitating and presenting to large audiences preferred.
Job Level:
Director Equivalent
Workshift:
1st Shift (United States of America)
Job Family:
BSP > Business Support
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