Provider Reimbursement Policy Lead

The Elevance Health Companies, Inc.; Indianapolis (IN); Híbrido; USD 81 000 - 134 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Comprehensive benefits package

401(k) + match

Stock purchase plan

Wellness programs

Resumo da oferta

Elevance Health is seeking a Provider Reimbursement Manager in the United States to lead reimbursement policy development and ensure accurate adjudication of claims while aligning with cost-of-care targets. You will translate complex coding and billing rules into practical rules and serve as a subject‑matter expert on reimbursement standards.

In this hybrid role, you will collaborate with multiple business areas to improve efficiency, accuracy, and financial performance, balancing policy with

Qualificações

• Requires BA/BS degree in a related field and a minimum of 7 years reimbursement experience including detailed financial modeling and economic analyses.

Responsabilidades

• Leads policy development for specific plan(s) and implementation of behavioral health reimbursement policy rules.
• Works with multiple business areas to ensure accurate cost of care targets are included in financial plans.
• Performs and/or directs complex research to ensure projected changes meet corporate cost targets.
• Prepares and presents cost of care data analysis to support regional cost of care initiatives.
• Develops and maintains provider reimbursement policies to lower cost of care and reduce admin expenses.

Conhecimentos

Provider reimbursement policy

Cost of care analysis

Financial modeling

Research and analysis

Communication

RN/Clinical background

Formação académica

BA/BS degree

Descrição da oferta de emprego

Elevance Health is seeking a Provider Reimbursement Manager in the United States to lead reimbursement policy development and ensure accurate adjudication of claims while aligning with cost-of-care targets. You will translate complex coding and billing rules into practical rules and serve as a subject‑matter expert on reimbursement standards.

In this hybrid role, you will collaborate with multiple business areas to improve efficiency, accuracy, and financial performance, balancing policy with