Anticipated End Date:

2025-01-19

Position Title:

Senior Implementation Specialist

Job Description:

Senior Implementation Specialist

Location: This position will work a hybrid model (remote and in office one day per week). Ideal candidates will live within 50 miles of one of our Pulse Point locations in Atlanta, GA, Wilmington, DE, Tampa, FL, Indianapolis, IN, Durham, NC, Norfolk, VA, Richmond, VA, Mason, OH, Cincinnati, OH, St. Louis, MO, Wallingford, CT, Grand Prairie, TX or Louisville, KY.

The Senior Implementation Specialist will be responsible for implementing payment integrity concepts and executing on all activities related to providing support, configuration, design, testing and implementation for ratings or claims systems.

How you will make an impact:

Develops, implements, and maintains payment integrity edits to drive cost saving results.

Works with business owners to identify and analyze requirements and processes with Information Technology and deploys the requirements to ensure quality and timeliness of systems/project deliverables.

Configures new designs/updates in the system.

Monitors system and business functionality and performance.

Documents and tracks product defects.

Coordinates problem resolution with development and/or product teams.

Analyzes, develops, and validates data.

Researches, documents, and completes very diverse and complex projects and work processes to ensure business continuity and consistency.

Formulates and defines system scope and objectives based on user-defined requirements.

Builds and maintains robust project documentation, including implementation plans, progress reports and post-implementation reviews.

Troubleshoots system issues, implements solutions and manages escalation processes.

Provides expertise to more junior analysts.

Minimum Requirements:

Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

Master’s degree in Business Administration, Computer Science, Healthcare Administration, or related field strongly preferred.

Strong understanding of data analysis, claims processing, and audit processes associated with healthcare payment models strongly preferred.

Expert-level experience in payment Integrity strongly preferred.

Extensive knowledge in payment ntegrity, claims analysis, and healthcare payment models strongly preferred.

Agile experience strongly preferred.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

IFT > IT Bus Systems Solutions Planning

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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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 may contact elevancehealthjobssupport@elevancehealth.com for assistance. 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.