Process Expert II (Medicaid Rx) jobs in United States
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Elevance Health · 11 hours ago

Process Expert II (Medicaid Rx)

Elevance Health is a health company dedicated to improving lives and communities. The Process Expert II (Medicaid Rx) role involves supporting operations through project and process work, ensuring compliance with Medicaid Programs, and providing subject matter expertise for external client-facing programs.

Health CareHealth InsurancePersonal HealthWellness

Responsibilities

Assists the Program Manager for Operations during mandate and project implementations
Supports the process for final approval of all operational requirements during requirement development and state mandate execution
Assists the Ops-Lead for state and health-plan-mandated Readiness Reviews and Audits
Day-to-day oversight of the processes related to Medicaid Programs for both pharmacy and medical injectables. Supporting responsibilities for ensuring completion of all reporting and contractual obligations
Impacts daily operational success and compliance risks regarding State audits, inquiries, complaints, and mandates
Supports the development, approval, implementation, and compliance of ongoing external client-facing programs; assists with developing program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day-to-day external client-facing business issues
Researches applicable subject matter practices and remains aware of industry trends

Qualification

Business analysisProcess improvementProject coordinationMedicaid Programs knowledgeWorkflow analysisSubject matter expertiseCommunication skills

Required

Requires a BA/BS and minimum of 5 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background

Preferred

Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred

Benefits

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

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

Funding

Current Stage
Public Company
Total Funding
unknown
2001-10-30IPO

Leadership Team

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Gail K. Boudreaux
President and CEO
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Geeta Wilson
Chief Technology Officer (CTO): Digital Health and Service Experience Platforms
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Company data provided by crunchbase