Business Strategy Plan Director- MedEx Management

Business Strategy Plan Director

Location : This role requires associates to be in-office three 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. 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. Alternate locations may be considered if the candidate resides within a commutable distance from an office.

The Business Strategy Plan Director- MedEx (Medical Expense) Management is responsible for managing the development and implementation of medical expense management initiatives for assigned Carelon Health business unit.

How You Will Make An Impact

• Oversees the development and execution of new and innovative initiatives specific to the Carelon Health, enterprise or one or more health plans, managing rising costs and enhancing the company's market competitiveness.
• Understands all aspects of the business and partners with executive leadership to define strategy and successful criteria for the future.
• Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, and operations.
• Oversees the identification of potential cost of care savings opportunities through complex analytics, development of action plans, benefits and risk assessments and partners with the actuarial team to develop and ensure accurate savings quantification.
• Champions cost of care initiatives, negotiates for human capital resources, and partners with care management, network, claims & operational teams, IT, and business partners.
• Builds and leverages relationships to provide innovative solutions to complex business problems.
• Proposes opportunities to improve results based on continuous needs assessment.
• Responsible for the development implementation and monitoring of line of business planning and project activities.
• Travels to worksite and other locations as necessary.

Minimum Requirements

Requires a BA / BS degree in a related field and a minimum of 10 years of related experience including prior leadership experience and 3 to 5 year strategic planning; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences

MBA, MHA and PMP or Six Sigma Green Belt strongly preferred. Financial, business, and leadership acumen strongly preferred. Prior experience with managed care, trend & healthcare analytics, provider networks, claims, finance, and operations strongly preferred. Healthcare payer experience strongly preferred. Cost of Care knowledge and experience preferred. Executive presence and the ability to influence preferred.

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.

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.