Senior Medical Policy Coding & Implementation Lead

Elevance Health (Anthem); Atlanta (GA); Hybrid; USD 79,000 - 136,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Incentive programs

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. The role supports cross-regional adjudication systems, benefit design, and regulatory environments with a focus on accurate code assignment and policy translation in the DMS.

The position requires a BA/BS and at least 5 years of medical policy experience, preferably with CPC certification.

Qualifications

• Requires a BA/BS degree and a minimum of 5 years of related medical policy experience including prior lead roles on large multi-stakeholder projects, or an equivalent background.

Responsibilities

• Conceptualizes implementation approaches across regions and adjudication systems.
• Assesses factors to evaluate coding options and recommend optimal approach.
• Optimizes enterprise policy implementation balancing clinical, coding, systems, cost, and provider relations.
• Communicates execution of policy implementation with clinical and operations stakeholders.

Skills

Coding

Policy analysis

Stakeholder management

Medical coding CPC

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. The role supports cross-regional adjudication systems, benefit design, and regulatory environments with a focus on accurate code assignment and policy translation in the DMS.

The position requires a BA/BS and at least 5 years of medical policy experience, preferably with CPC certification.