Anticipated End Date:
2026-11-30
Position Title:
Staff VP Digital Claims Operations
Job Description:
Staff Vice President, Digital Claims Operations
Location: May be located in any Elevance Health PulsePoint office preferably in Indianapolis, IN, Atlanta, GA, Mason, OH, Richmond, VA, Norfolk, VA, Chicago, IL or Woodland Hills, CA.
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.
Summary
The Staff Vice President, Digital Claims Operations is responsible for driving the digital transformation of claims processes within Health Benefits Operations. Reporting to the Vice President, Claims Operations, this leader integrates strategic planning, process optimization, analytics, and technology implementation to enhance operational efficiency, processing accuracy, and service quality across claims management.
The leader develops and executes a digital claims strategy aligned with company objectives and provides hands-on leadership for transformation initiatives involving AI, automation, advanced analytics, and end-to-end solution delivery. Serving as the claims analytics domain lead, the executive supports enterprise actuarial reserving and Cost of Care initiatives while managing the intersection of operations, analytics, and technology with deep claims expertise.
Leadership and Culture
The successful executive will combine enterprise perspective, disciplined execution, innovation, and strong stakeholder leadership. They will build a collaborative, high-performance team; identify and develop talent; clarify accountability; and foster an environment grounded in trust, inclusion, continuous learning, and measurable outcomes.
Strategic Mandate and Outcomes
Role Mandate
Develop and execute a digital claims strategy that aligns with company objectives and advances operational, financial, and service outcomes.
Integrate strategic planning, process optimization, analytics, AI, automation, and technology implementation into a cohesive transformation agenda.
Lead the claims analytics domain and support enterprise actuarial reserving, Cost of Care, and other priority business initiatives.
Oversee digital claims operations and the delivery of end-to-end solutions that improve efficiency, accuracy, productivity, and service quality.
Design and implement pilots to test strategies, validate value, assess scalability, and accelerate adoption of innovative capabilities.
Ensure digital claims operations meet applicable regulatory, compliance, control, and risk-management requirements.
Illustrative Measures of Success
A clear digital claims roadmap is established, aligned to business priorities, and translated into accountable delivery plans.
AI, automation, analytics, and process changes produce measurable improvements in productivity, quality, accuracy, and service performance.
Pilots are designed with defined hypotheses, performance measures, governance, and decisions regarding scale, refinement, or discontinuation.
Claims analytics effectively support operational decisions, actuarial reserving, and Cost of Care priorities.
End-to-end solutions are delivered with strong operating readiness, adoption, stakeholder alignment, and sustained benefit realization.
Budgets, risks, dependencies, and cross-departmental commitments are managed with transparency and discipline.
Digital claims operations consistently meet regulatory and compliance expectations.
Position…