Director Financial Operations Department - CarelonRx Revenue Cycle Management
Elevance Health, Indianapolis, IN, United States
Director Financial Operations Department - CarelonRx Revenue Cycle Management
Location:
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.
CarelonRx
is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health.
The
Director Financial Operations Department
coordinates, directs and manages operational areas of Finance. Leads and participates in committees and projects that are enterprise-wide in scope. will act as project sponsor.
How you will make an impact:
Counsels senior management on enterprise-wide policies and strategies.
Represents the company in legal matters and testifies as needed.
Develops and implements vision, strategies, and tactics to maximize the department's effectiveness while minimizing costs.
Ensures internal controls are appropriate and develops policies and procedures and ensures compliance with government regulations.
Works with other areas for solutions to complex problems and participates in critical interactions with both internal and external customers.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Requirements:
Requires a minimum of 8 years experience with operations, financial reporting and analysis, audit guidelines, budgeting and multi-state operations and processes and a minimum of 5 years management experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Prior leadership experience, including coaching, workflow oversight, training, or team lead responsibilities in a healthcare or claims environment.
Background in specialty pharmacy and infusion therapy operations (e.g., benefit verification, prior authorizations, coordination of care, site-of-care support).
Working knowledge of Major Medical and PBM claim adjudication, including medical vs. pharmacy benefit distinctions and payer processing nuances.
Experience supporting Medicare and Medicaid members, including familiarity with coverage requirements and payer-specific processes.
Strong understanding of medical billing terminology, payer systems, and claim adjudication processes.
Proficiency in RCM software systems and Microsoft Office Suite (especially Excel).
Excellent analytical, organizational, and communication skills.
Ability to prepare detailed reports, track financial performance, and present findings to executive leadership.
Experience with complex business environments including multiple entity and highly automated situations strongly preferred.
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, and 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.
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Location:
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.
CarelonRx
is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health.
The
Director Financial Operations Department
coordinates, directs and manages operational areas of Finance. Leads and participates in committees and projects that are enterprise-wide in scope. will act as project sponsor.
How you will make an impact:
Counsels senior management on enterprise-wide policies and strategies.
Represents the company in legal matters and testifies as needed.
Develops and implements vision, strategies, and tactics to maximize the department's effectiveness while minimizing costs.
Ensures internal controls are appropriate and develops policies and procedures and ensures compliance with government regulations.
Works with other areas for solutions to complex problems and participates in critical interactions with both internal and external customers.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Requirements:
Requires a minimum of 8 years experience with operations, financial reporting and analysis, audit guidelines, budgeting and multi-state operations and processes and a minimum of 5 years management experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Prior leadership experience, including coaching, workflow oversight, training, or team lead responsibilities in a healthcare or claims environment.
Background in specialty pharmacy and infusion therapy operations (e.g., benefit verification, prior authorizations, coordination of care, site-of-care support).
Working knowledge of Major Medical and PBM claim adjudication, including medical vs. pharmacy benefit distinctions and payer processing nuances.
Experience supporting Medicare and Medicaid members, including familiarity with coverage requirements and payer-specific processes.
Strong understanding of medical billing terminology, payer systems, and claim adjudication processes.
Proficiency in RCM software systems and Microsoft Office Suite (especially Excel).
Excellent analytical, organizational, and communication skills.
Ability to prepare detailed reports, track financial performance, and present findings to executive leadership.
Experience with complex business environments including multiple entity and highly automated situations strongly preferred.
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, and 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.
#J-18808-Ljbffr