Medical Policy Coding & Implementation Lead

The Elevance Health Companies, Inc.; Atlanta (GA); Hybrid; USD 79,000 - 136,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401(k) contribution

Job summary

Elevance Health is seeking an Implement & Coding Consultant to lead the development, implementation, and evaluation of policy coding strategies across the enterprise. The role emphasizes collaboration with clinical and operations teams to optimize adjudication systems while ensuring regulatory alignment.

A BA/BS and 5+ years of medical policy experience are required, with CPC strongly preferred. The position is hybrid, with in-office requirements and potential for alternate locations based on

Qualifications

• Requires a BA/BS degree and a minimum of 5 years of related medical policy experience including prior experience leading large, multi-stakeholder regional or enterprise projects.
• Certified Professional Coder (CPC) strongly preferred and experience reviewing clinical criteria and assigning codes.
• Ability to lead coding policy implementation across enterprise systems and regions.

Responsibilities

• Conceptualizes implementation approaches across regions considering adjudication systems, benefit design, and regulatory environments.
• Assesses factors to identify and evaluate coding options for policies and recommends optimal approaches.
• Communicates and monitors execution of policy implementation with clinical and operations stakeholders.
• Develops quality assurance processes to ensure accurate code assignment and translation in adjudication systems.

Skills

5+ years experience

CPC certification

Policy coding leadership

Education

BA/BS degree

Job description

Elevance Health is seeking an Implement & Coding Consultant to lead the development, implementation, and evaluation of policy coding strategies across the enterprise. The role emphasizes collaboration with clinical and operations teams to optimize adjudication systems while ensuring regulatory alignment.

A BA/BS and 5+ years of medical policy experience are required, with CPC strongly preferred. The position is hybrid, with in-office requirements and potential for alternate locations based on