Apply on Employer Site

Elevance Health · 8 hours ago

Manager Process Improvement - Payment Integrity

Miami, FL

Full-time

Hybrid

Mid, Senior Level

$107K/yr - $160K/yr

5+ years exp

Elevance Health is a health company dedicated to improving lives and communities. The Manager Process Improvement is responsible for building and leading a team to deliver advanced analytics and translate Payment Integrity insights into actionable strategies to enhance medical savings and payment accuracy.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

Oversees a team responsible for engaging the provider community using data-driven insights to support improved post-pay Payment Integrity outcomes, provider behavior change, and audit effectiveness

Partners closely with Payment Integrity audit, analytics, operations, and market leadership to prioritize opportunities, guide provider engagement strategies, and align actions with enterprise Payment Integrity objectives

Proactively identifies opportunities for improvement

Researches, develops, and implements related best practices

Develops metrics to track performance and goal achievement; serves as internal consultant relative to continuous improvement initiatives

Provides strategic oversight of provider-level analysis aligned by market and state, identifying emerging trends, utilization patterns, and anomalies by extending analytic thresholds and exploring non-obvious patterns within complex claims data

Accountable for team development, performance management, and ensuring consistent, high-quality delivery of analytics-informed provider engagement that supports recovery optimization, compliance, and sustainable medical savings

Qualification

Healthcare analyticsProcess improvementData analysisSix Sigma Black BeltProject managementProvider engagementTeam leadershipCross-functional collaboration

Required

Requires a BA/BS in a related field

Minimum of 5 years management experience with process improvement, project/program management, process engineering and/or performance improvement initiatives

Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law

Preferred

5 years of experience in healthcare analytics, payment integrity, provider performance, operations, or related healthcare functions preferred

Demonstrated experience using data and trend analysis to identify anomalies, utilization patterns, and opportunities that drive measurable medical savings preferred

Experience partnering with operations, product, and technology teams to identify opportunities to automate, digitize, and streamline analytics- and provider-facing workflows, improving efficiency, scalability, and impact of Payment Integrity initiatives preferred

Proven experience working cross-functionally with operations, product, and technology teams to modernize processes through automation and digital enablement, reducing manual effort and accelerating insight-to-action execution preferred

Six Sigma Black Belt certification, related process improvement certification or PMI certification preferred

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

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)