Manager Hospital Billing Audits (Registered Nurse) - Carelon Payment Integrity at Elevance Health

Manager Hospital Billing Audits (Registered Nurse) - Carelon Payment Integrity

Location : The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a hybrid work model (1-2 days per week in the office).

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 Manager Hospital Billing Audits is responsible for ensuring the overall success of multiple, cross-functional programs / projects through functional managers.

Programs may include cultural change, regional planning, process improvement, change management, and quality initiatives.

How you will make an impact :

Plans program / project scope and design.

Facilitates determination of required deliverables and validation of ROI.

Establishes a process to continually monitor program progress.

Develop metrics and program / project reporting tools.

Analyzes variance to program / project plan.

Leads building of documentation to support business objectives and ensure consistency.

Responsible for championing local stakeholders and tactical decision-makers.

Hires, trains, coaches, counsels, and evaluates the performance of direct reports.

Minimum Requirements :

Requires a BA / BS and minimum of 5 years experience in project / program management, process reengineering, organizational design, and / or implementation;

or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications, Skills, and Experiences :

Registered Nurse with current active license highly desired.

Experience performing Hospital Bill Audits, which includes comparing an itemized bill / UB04 to Medical Records strongly preferred.

Experience with a vendor performing Hospital Bill Audits or Itemized Bill Reviews desired.

Experience working with a Payment Integrity vendor that conducts audits on behalf of payers preferred.

Travels to worksite and other locations as necessary.

For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $110,160 to $198,288.

Locations : California; Colorado; District of Columbia (Washington, DC); Nevada; New York; Washington State

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company.

The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws -.-

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting.

This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and / or skill level.

Even within the range, the actual compensation will vary depending on the above factors as well as market / business considerations.

No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans.

The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Compensation Information :

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