Anticipated End Date: 2026-02-27 Position Title: Business Change Director - Payment Integrity Ideation Job Description: Business Change Director Carelon Payment Integrity Location: Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, 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. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Business Change Director is responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals. How you will make an impact: May specialize in one area of organization effectiveness (planning, project portfolio, or culture/change) or be assigned to directly support a business unit and ensures activities are aligned with corporate strategy. Identifies potential issues, project change, and scope data. Leads efforts to identify best practices. Identifies impacted parties, business partners, and resources required. Develops and designs processes and systems that support business needs. Designs methods for integrating functions and processes. Conducts cost/benefit analyses. Builds support for business change throughout the business unit. Provides process, project, and change management methodology coaching/consulting support to both local and enterprise wide initiatives. Leads the project prioritization and scheduling activities for the business unit. Provides expertise to the business areas in culture/change management activities. Provides expertise in process planning and portfolio management activities. Supports the execution of the operating plan. This role is responsible for developing new audit concepts through, but not limited to, the following: Data models CMS and state Medicaid guidelines, Researching provider billing trends being influenced by revenue cycle vendors, Other publicly available information Creates/audits reports and paid claims to identify overpayment of claims. The scope may include Data Mining, Claim Adjudication, Contract Compliance, Provider Billing Reviews, Policy & Reimbursement Analysis, and Quality Assurance across various lines of business. Actively seeks information to understand rationale and provide exceptional results beyond basic standards. Creates innovation to enhance the standard operating rhythm finding new pathways to complete work expectations Integrates information from various sources and considers broader context Identify and solve problems by identifying errors and overpayments within our Elevance enterprise Multi–functional in strategizing, disseminating, and implementing cross-audit concepts to Elevance functional areas and stakeholders. Minimum Requirements: Requires a BA/BS in a related field and minimum of 10 years managing mid to large-scale change/project initiatives; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: Advanced understanding of the healthcare industry, as well as proven track record of delivering results in creating new payment integrity overpayment ideas and concepts. Knowledge of planning models and methodology, project management and change management experience (strategic and execution) strongly preferred. Masters degree preferred. Six Sigma Black Belt preferred. Job Level: Director Equivalent Workshift: 1st Shift (United States of America) Job Family: BSP > Business Support 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. 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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration. Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading. Join our Talent Community and stay connected with company news, information, and future job opportunities. Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner.  Our nearly 100,000 associates serve approximately 100M+ people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health.  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 ehjobssupport@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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration Please visit the Contract Worker Community Page. Elevance Health is an Equal Opportunity Employer/Disability/Veterans.