Jobs at Elevance Health

Perform actuarial and statistical analyses to support commercial rate determination, update pricing and forecasting models, validate and prepare data, assist with regulatory filings, mentor analysts, and contribute to new product pricing and special projects.

Lead analysis and design of highly complex business needs into application requirements, mentor junior consultants, manage high-impact projects, and travel up to 20% to worksites. Serve as liaison between business stakeholders and technical teams to define solutions and ensure delivery.

Audit inpatient medical records to evaluate coding and DRG assignment accuracy (MS-DRG, APR-DRG), generate recoverable claims, produce audit findings, and recommend process improvements using ICD coding expertise and auditing tools.

Write, edit, and advise on marketing and sales communications (proposals, presentations, retention materials) for presale and acquisition/retention. Partner with business and creative teams, ensure legal and brand compliance, assess communication effectiveness, and recommend efficiency and clarity improvements.

Review and determine medical necessity for behavioral health outpatient services (including ABA and ASD), conduct precertification, concurrent review, and appeals, collaborate with providers and Medical Directors, mentor care management staff, and assist program development for psychological and neuropsychological testing.

Lead provider network development and contracting for large health systems and physician groups. Manage complex negotiations, mentor associates, support enterprise network initiatives, prepare financial projections and analysis, and collaborate with sales and cross-functional teams to develop customized fee schedules and value-based arrangements.

Designs, builds, evaluates, secures, and supports production AI-native software and agentic systems. Uses AI coding assistants across the SDLC; performs model evaluation, testing, integration, production support, and stakeholder-driven requirements analysis while enforcing secure, privacy-aware practices.

Lead strategy, design, and delivery of enterprise leadership development programs. Partner with senior leaders to define outcomes, facilitate executive learning, measure impact, and continuously improve the Executive Development portfolio.

Lead a regional team of Pharmacy Account Executives and Account Managers to drive client retention, profitability, and satisfaction for CarelonRx clients. Partner with health plan leadership and cross-functional teams to execute market strategies, resolve complex client issues, monitor regional performance, and ensure operational delivery. Hire, train, coach, evaluate staff, and oversee reporting and initiatives to support growth and client commitments.