Business Change Advisor – Carelon Payment Integrity

Jobtailor; Kentucky; On-site; USD 55,000 - 75,000; Full time

Job summary

Jobtailor in Kentucky is seeking a detail-oriented professional to support Payment Integrity initiatives, prepare executive visuals, and bridge gaps between current and desired performance levels. You will analyze data, create dashboards, and collaborate with Claims, SIU, Clinical Review, and Operations to drive process improvements and performance optimization.

This role requires a BA/BS and at least two years of related experience, with strong Excel, SharePoint, and Tableau skills for accurate

Qualifications

• Requires a BA/BS and minimum of 2 years related experience; or any combination of education and experience providing an equivalent background.
• Proficiency in preparing executive-facing PowerPoint presentations.
• Ability to synthesize complex information into clear visuals.
• Experience supporting Payment Integrity, Claims, or Healthcare Operations functions.
• Strong data entry accuracy and documentation management.

Responsibilities

• Assist management and the organization in bridging the gap between current and desired business performance levels.
• Balance short-term business needs with long-term perspectives on success.
• Help build and support the company’s change network.
• Support Payment Integrity-related process enhancements.
• Provide data entry and documentation support for Payment Integrity execution roles.
• Assist business units in implementing and tracking key activities.
• Communicate information through newsletters, dashboards, and presentations.
• Present claims accuracy insights and Payment Integrity program updates.
• Promote the benefits of the function within the region and throughout the company.
• Contribute to improving payment accuracy and reducing errors.

Skills

Payment Integrity Support

Claims Processing Experience

Executive Presentations

Data Entry Accuracy

Reporting Tools

Data Visualization

Education

BA/BS

Tools

Excel

SharePoint

Tableau

Internal Payment Integrity Platforms

Job description

• Assist management and the organization in bridging the gap between current and desired business performance levels
• Balance short-term business needs with long-term perspectives on success
• Help build and support the company’s change network
• Support Payment Integrity-related process enhancements
• Provide data entry and documentation support for Payment Integrity execution roles
• Assist business units in implementing and tracking key activities
• Communicate information through newsletters, dashboards, and presentations
• Present claims accuracy insights and Payment Integrity program updates
• Promote the benefits of the function within the region and throughout the company
• Contribute to improving payment accuracy and reducing errors

Requirements

• Requires a BA/BS and minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background
• Expertise in preparing executive-facing PowerPoint presentations
• Ability to synthesize complex information into clear visuals
• Experience supporting Payment Integrity, Claims, or Healthcare Operations functions
• Strong data entry accuracy
• Documentation management
• Ability to track Payment Integrity execution activities
• Familiarity with claims processing, overpayment identification, audit workflows, or financial accuracy processes
• Ability to interpret and communicate Payment Integrity metrics, trends, and operational updates
• Proficiency with reporting or workflow tools such as Excel, SharePoint, Tableau, or internal Payment Integrity platforms
• Strong attention to detail
• Ability to manage multiple data sources, queues, or workstreams
• Experience collaborating with Claims, SIU, Clinical Review, and Operations teams
• Demonstrated ability to support process improvements, change initiatives, and performance optimization efforts
• Must reside within a reasonable commuting distance from a posting location unless an accommodation is granted as required by law

Core Competencies

Demonstrates expertise in Payment Integrity processes, including claims accuracy and documentation management, while effectively communicating insights through executive presentations and data visualization. Proven ability to support process improvements and manage multiple workstreams to enhance business performance.

Highest-signal resume keywords

• Payment Integrity Support
• Claims Processing Experience
• Executive-Facing PowerPoint Presentations
• Data Entry Accuracy
• Reporting Tools Proficiency

Hard Skills

• Payment Integrity
• Claims Processing
• Documentation Management
• Data Entry Accuracy
• Process Improvement
• Performance Optimization
• Change Initiatives
• Financial Accuracy
• Audit Workflows
• Overpayment Identification

Soft Skills

• Attention to Detail
• Communication Skills
• Collaboration
• Synthesis of Complex Information
• Ability to Manage Multiple Workstreams

Industry Keywords

• Healthcare Operations
• Payment Integrity Metrics
• Claims Accuracy Insights
• Operational Updates

Tools & Technologies

• Excel
• SharePoint
• Tableau
• Internal Payment Integrity Platforms