Jobs at Elevance Health

Develops and executes regional sales strategies for BioPlus Specialty Infusion across New Jersey and Manhattan. Builds relationships with healthcare providers, clinical teams, pharmaceutical partners, and key accounts; supports infusion activity, education, reimbursement processes, and referral growth. Uses Salesforce and databases to track sales activity and performance, maintains call cycles, communicates market intelligence, and attends meetings, conferences, and training while traveling 50%–70% within the territory.

Leads actuarial pricing and financial risk analysis for individual health insurance products. Develops pricing strategies, rate filings, profitability recommendations, and financial performance evaluations for non-Blue states. Partners with pricing teams to align with financial targets, represents Actuarial on cross-functional projects, provides certification or sign-off on filings, and directs workflow for Individual pricing activities.

Screens and assesses behavioral health helpline callers through calls, texts, and chats; provides crisis intervention and de-escalation, safety planning, resource coordination, documentation, and follow-up. The role operates in a 24/7 call-center environment and requires compliance with HIPAA, OSHA, and applicable regulations.

Leads enterprise cloud and infrastructure strategy, delivery, adoption, portfolio governance, customer success, FinOps, financial management, service performance, and operational excellence. Oversees cloud modernization, capacity planning, executive reporting, governance, strategic vendors, and cross-functional alignment across technology, finance, security, architecture, engineering, and business teams. Builds and develops a 30-person organization while driving accountability, reliability, cost optimization, and measurable business outcomes.

Provides enterprise-wide legal counsel on technology matters, including AI, SaaS, software as a medical device, data use, and digital health product development. Negotiates technology agreements, advises sales teams on RFPs, assesses regulatory risks, develops contract templates and negotiation playbooks, and supports risk mitigation, strategic legal analysis, and internal education.

Audits inpatient medical records and claims to validate coding and DRG assignments, identify recoverable claims, and produce audit findings. Applies advanced ICD-10-CM expertise, clinical guidelines, and reimbursement knowledge across MS-DRG, AP-DRG, and APR-DRG. Reviews documentation for coding accuracy, identifies additional recovery opportunities, maintains audit quality standards, and recommends process improvements.

Develops and executes CarelonRx sales strategies across assigned territories, targeting commercial ASO clients with 250+ members. Leads complex account sales, prospecting, broker and consultant engagement, pharmacy pricing, RFP execution, finalist meetings, pipeline forecasting, and market intelligence initiatives. Partners with implementation teams to ensure successful client transitions and communicates CarelonRx solutions to plan sponsors and external stakeholders.