Jobs for People with MS: National MS Society

Process Expert Senior

Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.

The Process Expert Senior supports multiple operations departments by participating in project and process work.

How you will make an impact:

• Researches operations workflow problems and system irregularities; develops, tests, presents process improvement solutions for new systems, new accounts and other operational improvements; develops and leads project plans and communicates project status; provides process direction and decision making for all minor and major project work; provides guidance to process experts.

• May perform duties as a lead when involved with enterprise wide initiatives/projects.

Minimum Requirements:

• Requires a BA/BS and minimum of 8 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 Skills, Capabilities, and Experiences:

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

• 8-10 years of extensive experience in comprehensive COB auditing with complex concepts, covering across all lines of business.

• Subject matter expert in every aspect of COB, with a comprehensive understanding of all NAIC guidelines and Medicare Secondary Payer Rules across all business sectors.

• Advanced COB SQL query ideation experience. Proficient in conducting detailed investigative research and performing necessary outreach (e.g., OHI, CMS, employers, ESRs) to ensure accurate validation of order of benefits and eligibility updates.

• Ability to generate and implement innovative ideas, approaches, and processes to enhance savings opportunities and operational efficiencies.

• Exceptional analytical and problem-solving expertise.

• Excellent communication skills, both verbal and written.

• Re-auditing to identify opportunities for training and providing constructive feedback.

• Experienced in training, coaching, and mentoring others.

• Supportive of UAT testing and proficient in data validation and reporting analysis.

For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $82,404 to $141,264.

Locations: California; Colorado; District of Columbia (Washington, DC), Illinois; Maryland, Minnesota, New York; Washington State

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.