Operations Expert

Elevance Health; Florida; Hybrid; USD 80,000 - 110,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Elevance Health is seeking an Operations Expert to provide technical direction and resources to operations, claims, customer service, or membership teams on a day-to-day basis. The role emphasizes guidance, training, and ensuring smooth workflows across departments.

The ideal candidate will have strong communication, problem-solving, and analytical skills, with experience in automated processing systems and a proven ability to multi-task in a fast-paced environment. Hybrid work schedule offered.

Qualifications

• Requires HS diploma or equivalent and a minimum of 5 years related experience including at least 3 years with company-relevant automated processing systems.
• URAC-accredited areas require strong oral, written and interpersonal communication, problem-solving, facilitation and analytical skills.

Responsibilities

• Provide technical direction, guidance and resources to operations, claims, customer service, or membership associates on a day-to-day basis.
• Serve as a first line resource for workflow and technical processes; provide operational training; assist associates with day-to-day technical questions; encourage teamwork; monitor workflow and productivity; review policies for accuracy.
• Assist associates with multi-tasking across calls, texts, faxes and electronic queues while taking notes and communicating with customers.
• Maintain focus in a fast-paced, high-pressure environment; communicate effectively both verbally and in writing; demonstrate empathy and persistence to resolve issues.
• Adhere to scheduled hybrid work pattern with occasional overtime and office presence as needed; perform other duties as assigned.

Skills

Leadership experience

Oral communication

Written communication

Interpersonal skills

Problem-solving

Facilitation skills

Analytical skills

Education

HS diploma or equivalent

Job description

Operations Expert

Location: Hybrid 1: This role requires associates to be in-office 1 - 2 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 accommodation is granted as required by law.

The Operations Expert is responsible for providing technical direction, guidance and resources to operations, claims, customer service, or membership associates on a day-to-day basis.

How you will make an impact:

• Provide technical direction, guidance and resources to operations, claims, customer service, or membership associates on a day-to-day basis.
• Serves as a first line resource for operation associates for workflow and technical related processes; provides operational training; assists associates by answering day to day technical questions; encourages a teamwork environment; monitors inventory to ensure workflow remains uninterrupted; handles complex case research and resolution; reviews, interprets and maintains records of service level, quality, accuracy, and productivity; reviews department policy and procedure manuals for accuracy; works with training department to ensure procedures and policies are accurate and complete.
• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
• Additional expectations to include but not limited to Proficient in maintain focus during extended periods of sitting and handling multiple tasks in a fast paced, high pressure environment; strong verbal and written communication skills, both with virtual and in person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.
• Performs other duties as assigned.

Minimum Qualifications

• Requires HS diploma or equivalent and a minimum of 5 years related experience which includes a minimum of 3 years of directly related experience with company relevant automated processing systems; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• Previous leadership experience preferred.
• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem- solving skills, facilitation skills, and analytical skills.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.