Manager I, GBD Special Programs (UM)

Elevance Health • Roanoke, VA

30d • Remote

About The Position

LOCATION: This is a virtual eligible role. Virginia residency is required. HOURS: General business hours, Monday through Friday. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Responsible for supporting the Medicaid Medical Management team by managing and overseeing non-clinical medical management specialists to ensure utilization regulatory compliance and member service delivery.

Requirements

• Requires a BA/BS and minimum of 5 years experience in a related field, including minimum of 1 year leadership/management experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Utilization review/utilization management experience is a must for this position.
• A current unrestricted RN license issued by the Commonwealth of Virginia is very strongly preferred.
• Experience monitoring associate productivity (i.e. metrics) is preferred.
• Prior experience in Medicaid, FIDE, and LTSS markets is very helpful.
• Your must be computer literate and be comfortable using a variety of applications, especially Word and Excel.
• Strong critical thinking and organizational skills are essential for this role.

Responsibilities

• Oversees compliance with turnaround times, productivity metrics, reporting, and call times.
• Supervises approximately 20 non-clinical medical management specialists.
• Manages resource utilization to ensure appropriate delivery of care to members, adequate coverage for all tasks and job responsibilities.
• Participates in cross-functional workgroups created to maintain and develop program.
• Evaluates current processes of Special Program's support functions; recommends changes for increased efficiencies and improved outcomes.
• Develops and conducts training programs for staff involved in the program.
• Extracts and manipulates analytical data to present findings to relevant markets and stakeholders.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Industry: Insurance Carriers and Related Activities
• Number of Employees: 5,001-10,000 employees