Staff VP Digital Claims Operations

Elevance Health•Indianapolis, IN

11d•$202,000 - $348,450•Hybrid

About The Position

The Staff Vice President, Digital Claims Operations drives the digital transformation of claims processes within Health Benefits Operations. Reporting to the Vice President, Claims Operations, this executive integrates strategic planning, process optimization, analytics, and technology implementation to improve operational efficiency, processing accuracy, and service quality across claims management. The role develops and executes a digital claims strategy aligned with company objectives and leads transformation initiatives involving AI, automation, advanced analytics, and end-to-end solution delivery. As the claims analytics domain lead, the executive supports enterprise actuarial reserving and Cost of Care initiatives and connects claims operations, analytics, and technology. The position also oversees digital claims operations, pilots, budgets, cross-departmental delivery, performance management, regulatory compliance, and risk controls. The successful leader builds a collaborative, high-performance team; develops talent and accountability; and fosters trust, inclusion, continuous learning, innovation, and measurable outcomes. The position is hybrid and requires associates to work in an office three days per week. It may be based at an Elevance Health PulsePoint office, preferably in Indianapolis, Atlanta, Mason, Richmond, Norfolk, Chicago, or Woodland Hills; alternate locations may be considered for candidates within commuting distance of an office. The posted salary range for Virginia, California, and Illinois is $202,000 to $348,450. Compensation varies based on factors including location, experience, education, and skills. Elevance Health describes a comprehensive benefits package, including incentive and recognition programs, equity stock purchase, and 401(k) contributions, subject to eligibility requirements.

Requirements

Bachelor of Arts or Bachelor of Science degree in Information Technology, Computer Science, or a related field.
At least 15 years of claims operations management and digital transformation experience.
Proven leadership and team management skills.
Strong analytical and communication abilities.
In-depth understanding of industry regulations and compliance standards.

Nice To Haves

Advanced degree in business, technology, analytics, healthcare administration, or a related field.
Experience leading AI, automation, analytics, process optimization, and technology-enabled change in a complex, matrixed organization.
Experience managing budgets, cross-functional portfolios, major implementations, and end-to-end solution delivery.
Executive-level experience leading digital claims operations within a large healthcare enterprise.
Experience supporting actuarial reserving, Cost of Care, payment integrity, or related financial and analytical priorities.
Experience scaling AI and automation from pilot through production with strong governance, adoption, and benefit-realization disciplines.
Success integrating claims operations, analytics, technology, product, provider data management and configuration, and change management into a cohesive operating model.

Responsibilities

Develop, communicate, and execute the digital claims strategy and transformation roadmap, translating company and claims priorities into sequenced initiatives, investment choices, operating changes, and measurable outcomes.
Lead transformation initiatives involving AI, automation, analytics, workflow redesign, and digital capabilities; identify opportunities to simplify processes, reduce manual work, improve decision quality, and strengthen member and provider service.
Serve as the claims analytics domain lead, connecting operational questions to data, insights, decisions, and actions; support actuarial reserving and Cost of Care initiatives.
Partner with Finance, Actuarial, Analytics, Technology, and Claims leaders to define priorities, requirements, controls, and success measures.
Oversee digital operations for efficient, accurate, and timely claims processing, and lead end-to-end solution delivery from opportunity definition and requirements through implementation, adoption, monitoring, and optimization.
Coordinate cross-departmental projects, resolve dependencies, establish decision rights, and maintain accountability for commitments; manage budgets and resource priorities.
Design and implement pilots for strategies, workflows, analytical approaches, AI, automation, and other technologies; define hypotheses, measures, controls, and scale decisions.
Monitor performance metrics and use insights and feedback loops to improve productivity, service quality, processing accuracy, models, automation, controls, processes, and frontline execution.
Collaborate with IT and other departments on technology upgrades, implementations, integration, and operating readiness; engage stakeholders, communicate priorities and risks, and sustain adoption.
Promote responsible use of AI and automation with appropriate governance, controls, monitoring, and accountability.
Ensure regulatory compliance and embed applicable policies, controls, audit readiness, privacy, security, and risk-management expectations into solution design and operating practices; partner with Compliance, Legal, Risk, Technology, and Operations to address issues.
Lead and mentor a high-performance team; hire, train, coach, counsel, and evaluate direct reports; develop talent, succession depth, and capabilities across claims operations, analytics, digital product leadership, process optimization, AI, automation, and change execution.