Strategic Planning Director - Payment Integrity

Elevance Health • Atlanta, IN

4d • Hybrid

About The Position

Strategic Planning Director - Payment Integrity 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. Carelon , a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center—connecting physical, behavioral, social, and pharmacy services, along with clinical expertise, research, operations, and advanced technology to help care work better, together. Among us are care providers, engineers, data scientists, and other dedicated professionals determined to recover, eliminate and prevent unnecessary medical-expense spending. The Strategic Planning Director - Payment Integrity is responsible for managing the enterprise wide planning process for a VP and above, with a primary focus on advancing payment integrity strategy, strengthening end-to-end processes, and driving measurable improvements in cost avoidance, recovery, and prevention.

Requirements

• Requires a BA/BS degree in a related field and a minimum of 10 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• 3-5 years of experience in Payment Integrity is strongly preferred.
• Experience in payment integrity: claim editing, recoveries, cost of care, or financial project management is highly desired.
• Experience in successfully developing and managing projects with significant operating budgets and knowledge of process redesign is strongly preferred.
• Project management experience desired.
• Experience with claims processing systems, such as GBD Facets and/or WGS highly desired.
• Experience facilitating and presenting to large audiences preferred.
• Experience in successfully developing and managing projects with a fairly significant operating budget.
• Knowledge of process redesign is strongly preferred.

Responsibilities

• Directs the monthly/quarterly reporting process and annual operating plan development, ensuring alignment with payment integrity performance goals and value realization targets.
• Ensures strategic rationale and initiatives are in sync with corporate direction and enterprise payment integrity objectives.
• Develops the annual business plan and quarterly forecast materials and tools, incorporating process improvement priorities and operational efficiency metrics.
• Coaches business planning participants on requirements, analysis, and deadlines, with emphasis on disciplined execution, root cause analysis, and continuous process improvement.
• Manages strategic payment integrity projects, reports, and analyses, identifying opportunities to enhance accuracy, efficiency, and scalability.
• Leads the development and direction of selected issues and projects, driving cross-functional process optimization and sustainable performance improvement.

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: Director