Lead Medical Policy Coding & Implementation

Elevance Health; Norfolk (VA); Hybrid; USD 79,000 - 136,000; Full time

Benefits offered by this job

Hybrid work

Medical benefits

401(k) plan

Job summary

Elevance Health is seeking an Implement & Coding Consultant to lead the development, implementation, and evaluation of corporate medical policy coding strategies across the enterprise. This role influences regional and enterprise policy design, collaborating with clinical and operations teams to align objectives.

Key duties include analyzing adjudication systems, providing coding guidance, and coordinating CMS/AMA updates.

Qualifications

• BA/BS degree required with 5+ years of medical policy experience.
• CPC certification strongly preferred.
• Experience leading large, multi-stakeholder regional or enterprise projects.

Responsibilities

• Lead development, implementation, and evaluation of coding strategies across the enterprise.
• Assess factors to identify optimal implementation and coding options for policies.
• Communicate and monitor execution of policy implementation with clinical and operations teams.
• Support Medical Policy Research and maintain Coding sections in documents.
• Develop QA processes to ensure accurate code assignment and translations.
• Compile and communicate CMS/AMA coding updates and respond to inquiries.
• Manage materials for weekly Coding & Implementation meetings.
• Lead work groups and resolve local implementation issues.

Skills

Policy analysis

Coding guidance

Project leadership

Education

BA/BS degree

Job description

Elevance Health is seeking an Implement & Coding Consultant to lead the development, implementation, and evaluation of corporate medical policy coding strategies across the enterprise. This role influences regional and enterprise policy design, collaborating with clinical and operations teams to align objectives.

Key duties include analyzing adjudication systems, providing coding guidance, and coordinating CMS/AMA updates.