Jobs at Elevance Health

Leads process improvement and continuous improvement initiatives for a business unit. Identifies opportunities, researches and implements best practices, develops performance metrics, consults internally, and creates enterprise-wide improvement plans. Requires extensive process improvement, planning, project management, business analysis, and leadership experience, with preferred expertise in PBM claims, SQL, Teradata, Python automation, vendor management, Lean Six Sigma, prior authorization, eligibility, and Salesforce.

Leads the architecture, development, and deployment of enterprise-scale AI systems and platforms. Establishes technical direction, governance, architecture standards, and responsible AI practices while modernizing legacy systems through code transformation and service decomposition. Develops AI-enabled SDLC practices, partners with engineering teams to drive adoption, and provides technical leadership and mentorship across software engineering, distributed systems, cloud, APIs, microservices, and DevOps.

Analyzes, researches, coordinates, and reports on provider data for internal teams, providers, and regulatory agencies. The role generates reports, performs network and file analysis, supports surveys and ad hoc data requests, validates report accuracy, coordinates with stakeholders, and serves as a technical liaison for provider database information. Responsibilities may also include data support, system enhancements, and testing.

Leads enterprise workflow modernization and architecture while designing scalable AI solutions, distributed systems, integrations, and digital products. Establishes technical standards, governance, responsible AI practices, and AI-enabled SDLC improvements. Partners with product, design, architecture, security, operations, and business teams to deliver secure, resilient workflow experiences. Provides hands-on technical leadership, mentorship, modernization strategy, and guidance on enterprise AI investments.

Translates complex PBM business needs into software requirements and solutions. Leads analyst teams, conducts claims and business impact analyses, investigates operational issues, performs root cause analysis, evaluates risks, develops remediation recommendations and business cases, and presents findings to leadership. Partners with Operations, Product, Technology, Finance, Compliance, and Client Services to improve processes, strengthen controls, and support PBM operations initiatives, compliance, audits, and contractual obligations.

Leads enterprise-wide continuous improvement initiatives using Lean Six Sigma, process optimization, and operational excellence methods. Identifies improvement opportunities, develops best practices and performance metrics, provides internal consulting, and drives cross-functional implementation. Directs project teams, develops data-driven recommendations, manages multiple initiatives, and presents executive-level insights. Requires significant process improvement, project management, business analysis, and leadership experience, with healthcare payer experience and Lean Six Sigma expertise preferred.

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.

Leads requirements gathering, change requests, technical design and code reviews, testing, application enhancements, system monitoring, vendor evaluation, and technical guidance. The role requires developing and administering IBM FileNet, advising cross-functional teams, researching technologies, maintaining development environments, coordinating support, mentoring others, and leading small to medium-sized projects.

Generates and qualifies sales leads through outbound email, phone, and social outreach. Conducts market research, nurtures prospects, schedules discovery meetings, analyzes campaign performance, and reports pipeline results. The role optimizes lead-generation processes, maintains CRM data quality, collaborates cross-functionally on solutions and launches, and ensures activities follow applicable regulations and best practices.

Leads enterprise AI adoption by evaluating vendors, models, platforms, and emerging technologies; designing reusable agentic frameworks and reference architectures; developing prototypes and proofs of concept; and enabling scalable, secure AI solutions. Partners with business, engineering, security, legal, compliance, and procurement teams to define adoption standards, evaluate tradeoffs, and guide AI investments across cloud, distributed systems, APIs, microservices, and DevOps environments.

Assists with actuarial rate determination, statistical analysis, pricing, valuation, and forecasting models. Collects, validates, and refines data; applies actuarial tools; and communicates findings and recommendations to colleagues, business partners, and leadership. The role requires a bachelor’s degree and at least one SOA or CAS actuarial exam, with additional exams, analytical programming experience, and healthcare interest preferred.