Operations Expert (US) at Elevance Health

Mayagüez, Puerto Rico, Puerto Rico

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

HS diploma or equivalent
Minimum of 5 years related experience
Minimum of 3 years of experience and expertise with company relevant automated processing systems (or any combination of education and experience which would provide an equivalent background)
Ability to work hybrid schedule: in-office 3 days per week at 2 KM 159, STE 301 MAYAGUEZ, PR 00682 (candidates not within reasonable commuting distance not considered unless accommodation granted)
100% attendance during full on-site training period (Monday-Friday, 8:00 AM – 5:30 PM EST for first 16 weeks starting 12/1/2025)
Ability to work 8-hour shift on scheduled rotating basis 7am – 11pm EST

Responsibilities

Serves as a first line resource for operation associates for workflow and technical related processes
Provides operational training
Assists associates by answering day-to-day technical questions; encourages a teamwork environment
Monitors inventory to ensure workflow remains uninterrupted
Handles complex case research and resolution
Reviews, interprets and maintains records of service level, quality, accuracy, and productivity
Reviews department policy and procedure manuals for accuracy
Works with training department to ensure procedures and policies are accurate and complete

Skills

Claims Processing

Customer Service

Workflow Management

Technical Support

Operational Training

Case Research

Quality Assurance

Productivity Monitoring

Policy Review

Inventory Management

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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