Location: Ideal candidates will live within 50 miles of one of our Pulse Point Locations and will work a hybrid work model (1-2 days per week in the office).

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology, and oncology.

The Solutions Management Manager is responsible for leading the planning and implementation of products and services for a line of business enterprise-wide. Serves as the single point of contact and subject matter expert on all aspects of planning, implementing, and managing day-to-day operational, technical, and business partner interactions for existing programs and works together with Product Development to consult on enhancements to existing products and development of new clinical solutions based on analytics.

How you will make an impact:

• Provides consultation and advice to business partners regarding the benefits of products and analytics.
• Explains timelines and measures of success for implementing these products.
• Coordinates with the Physician Liaison regarding clinical issues related to clinical measure implementation or customization by line of business and communicates changes to Product Development for consideration in product performance and financial analyses.
• Schedules and coordinates implementation of contracted products and services for assigned business partners.
• Coordinates data requirements, production schedules, and deliverables with the business partner.
• Oversees all business partner specifications and/or modifications for contracted products and services.
• Provides business partners with the resources, training, and services necessary to effectively utilize the products that the department provides.
• Analyzes business partner data for QA and identification of opportunities for business partners to utilize products and services to improve plan performance.
• Maintains detailed knowledge of current clinical measures and future clinical measure development plans, communicates this information to business partners, assists in the selection of clinical measures to be utilized in the pilot and full rollout of products and services, and guides business partners in continually reviewing and updating clinical measure sets.
• Maintains detailed knowledge of all current systems, products, and services and a basic understanding of future system and product development plans to allow an appropriate level of communication with business partners.
• Leads department projects and mentors solutions management staff.

Minimum Requirements:

• Requires a BA/BS and minimum of 5 years experience in a related field, including minimum of 2 years experience in solutions management; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications, Skills, and Experiences:

• Graduate degree and/or professional designation related to field preferred.
• Project management experience preferred.
• Working knowledge of all Microsoft Office Products desired.
• Understanding of Medical Processing of HCPCS and CPT codes is highly preferred.
• Understanding of Pharmacy Processing of NDC and GPI codes is highly desired.
• Prior Authorization processing knowledge is highly preferred.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $95,360 to $171,648.

Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

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.