Enrollee Services Program Manager at Elevance Health

Washington, District of Columbia, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

BA/BS degree and minimum of 5 years external client facing experience in program/project management (or equivalent combination of education and experience)
Familiarity with Salesforce (preferred)
Experience with Tableau (strongly preferred)
Grievances and appeals experience (strongly preferred)
Enrollee Services experience (strongly preferred)

Responsibilities

Oversee the Enrollee services program, including providing information, answering questions, assisting Enrollees with locating services, maintaining eligibility in a timely fashion, resolving Enrollee Grievances, assisting with filing and pursuing Appeals involving denial, termination, or reduction of benefits and services, and serving as the primary point of contact for the DHCF Ombudsman
Manage and coordinate the development and compliance of ongoing external client-facing programs
Ensure the program meets its stated objectives
Provide subject matter expertise in response to day-to-day external client-facing business issues
Research applicable subject matter practices and remain aware of industry trends
Manage member-facing relationships and partner with corporate and regional business areas
Coordinate training for wellness centers with a member satisfaction purpose
Develop program success measures and perform periodic assessments of program success

Skills

Program Management

Project Management

Salesforce

Tableau

Grievances

Appeals

Enrollee Services

Client Facing

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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