Health Services Director - Carelon Behavioral Health

Health Services Director - Carelon Behavioral Health

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. 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. Alternate locations may be considered.

The Health Services Director is responsible for clinical licensing, enterprise clinical license contracting, denial rationale, auditing, compliance reporting and overall direction for Carelon BH. This person is also responsible for designing, implementing, directing and evaluating strategic programs and external strategic relationships to support clinical, quality-related or business goals for the company and business unit.

How you will make an impact:

• Directs forecasting activities of the business unit focused on setting and achieving short and long-term strategic goals.
• Reports project status and progress to senior management.
• Ensures accuracy and timeliness of output and deliverables for assigned functional areas.
• Implements and ensures compliance with corporate management policies, practices, and procedures.
• Has fiscal responsibility for area budgets.
• Establishes relationships with business users.
• Participates with other senior management to establish strategic plans and objectives (i.e. service level targets, financial targets, development and implementation of new programs).
• Delivers analyses and project updates to all areas requiring information for management reporting, analysis and executive decision making.

Minimum Requirements:

• Requires a BA/BS and a minimum 7 years related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• MS/MA degree preferred.
• Extensive knowledge of clinical processes.
• Experience with NCQA requirements.
• Clinical license is strongly preferred.

For candidates working in person or virtually in the below location(s), the salary range for this specific position is $123,552 to $193,752.

Locations: District of Columbia (Washington, DC), Illinois

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.