Business Strategy Plan Director- MedEx Management at Elevance Health

Indianapolis, Indiana, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

BA/BS degree in a related field
Minimum of 10 years of related experience, including prior leadership experience and 3 to 5 years of strategic planning (or equivalent combination of education and experience)

Responsibilities

Oversee the development and execution of new and innovative medical expense management initiatives for assigned Carelon Health business unit, managing rising costs and enhancing market competitiveness
Partner with executive leadership to understand all aspects of the business and define strategy and success criteria for the future
Identify and develop best practices and cost of care improvement processes around physician, hospital, and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, and operations
Oversee the identification of potential cost of care savings opportunities through complex analytics, development of action plans, benefits and risk assessments, and partner with the actuarial team to develop and ensure accurate savings quantification
Champion cost of care initiatives, negotiate for human capital resources, and partner with care management, network, claims & operational teams, IT, and business partners
Build and leverage relationships to provide innovative solutions to complex business problems
Propose opportunities to improve results based on continuous needs assessment
Manage the development, implementation, and monitoring of line of business planning and project activities
Travel to worksite and other locations as necessary

Skills

Business Strategy

Medical Expense Management

Cost of Care Analytics

Contract Negotiation

Utilization Management

Benefit Design

Actuarial Partnership

Executive Leadership

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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