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Elevance Health · 18 hours ago

Director Special Programs-Clinical Advisory

Durham, NC

Full-time

Hybrid

Senior Level, Lead/Staff

8+ years exp

Elevance Health is a health company dedicated to improving lives and communities. The Director Special Programs-Clinical Advisory is responsible for directing and overseeing the operations of clinical advisory teams supporting care management for the Children and Families Specialty Plan, focusing on program performance, process improvements, and managing interdependencies and risks.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

Directs and oversees program operations in support of corporate and health plan management in execution of clinical service delivery

Monitors national and local health plan market trends relative to the clinical span of the program

Leads and/or participates in cross-functional workgroups created to maintain and develop clinical programs

Evaluates all facets of the clinical program to improve efficiency of operations, financial return, customer service, and provider engagement

Develops, communicates, and monitors program schedule, budget, and resources plan; coordinates program deliverables and resolves issues that may hinder clinical program success

Hires, trains, coaches, counsels, and evaluates performance of direct reports

Qualification

Clinical management experienceMedicaid services knowledgeIntegrated care managementRNLSWLPN/LVN licenseProgram performance evaluationCoaching skillsLeadership skillsCommunication skills

Required

Requires a BA/BS and minimum of 8 years experience in a related field, including prior management experience and clinical, quality, and/or utilization management experience in a managed care setting; or any combination of education and experience, which would provide an equivalent background

Preferred

MBA or MHA preferred

RN, LSW, or LPN/LVN license strongly preferred

Prior experience working managing or leading integrated care management in a LME/MCO, (NC Medicaid Direct or Tailored Plan members) or provider-led Tailored Care Management via an Advanced Medical Home Plus (AMH+) practices or Care Management Agency (CMA)

Experience and comprehensive understanding of Medicaid services for CWCN (Children With Complex Needs) and SED (Serious Emotional Disturbance), including 1915i and In Reach activities

Demonstrated experience in coordinating provider services

Benefits

Sign on Bonus: $7500.00

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical

Dental

Vision

Short and long term disability benefits

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Company

Elevance Health

Glassdoor3.6

Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.

Founded in 1944

Indianapolis, Indiana, USA

10001+ employees

https://www.elevancehealth.com

H1B Sponsorship

Elevance Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (488)

2024 (604)

2023 (660)

2022 (222)