Implementation Consultant, Coding

Elevance Health

. Lead development, implementation, and evaluation of Corporate Medical Policy coding strategies across the enterprise .

Posted 10/16/2026full-timeUnited StatesMid-LevelSenior💰 $78,800 - $135,929 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Corporate Medical Policy coding strategies, with a strong focus on implementation, evaluation, and optimization across clinical and operational domains. Proficient in leading multi-stakeholder projects and ensuring compliance with coding standards and regulatory requirements.

Highest-signal resume keywords

Corporate Medical Policy DevelopmentCertified Professional Coder (CPC)Coding Analysis and ImplementationMulti-Stakeholder Project LeadershipQuality Assurance Processes

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Coding Strategy DevelopmentCode AssignmentClinical Criteria ReviewImplementation EvaluationPolicy DocumentationAdjudication SystemsCost AnalysisProvider RelationsPerformance StandardizationCoding Updates Compilation

Soft Skills

CommunicationFacilitationStakeholder EngagementProblem-SolvingTeam Leadership

Tools & Technologies

Document Management SystemAdjudication Systems

Certifications & Qualifications

Certified Professional Coder (CPC)

Industry Keywords

Medical PolicyCoding GuidanceCMS UpdatesMPTAC DecisionsQuality AssuranceRegulatory Compliance

About the role

Key responsibilities & impact

Lead development, implementation, and evaluation of Corporate Medical Policy coding strategies across the enterprise
Conceptualize implementation approaches considering business objectives, adjudication systems, benefit design, and regional regulatory environments
Assess business and technical factors to evaluate implementation and coding options and recommend optimal approaches
Optimize enterprise policy implementation solutions across clinical, coding, systems, cost, and provider relations considerations
Communicate and monitor policy implementation execution with clinical and operations stakeholders
Create and maintain the Coding section of enterprise medical policy and clinical UM guideline documents
Support the Medical Policy Research team
Develop quality assurance processes for accurate code assignment and translation within adjudication systems
Compile and classify quarterly coding updates from CMS and the AMA
Communicate coding updates related to MPTAC decisions
Provide coding analysis and respond to coding inquiries, including shared mailbox coverage
Manage materials for weekly Coding & Implementation meetings and facilitate meetings as needed
Maintain the department Document Management System, including code entry, QA processes, and report releases
Improve processes, tools, and measures to standardize performance and demonstrate quantifiable business value
Lead work groups and facilitate resolution of local implementation issues
Complete other duties as assigned

Requirements

What you’ll need

BA/BS degree
Minimum of 5 years of related medical policy experience
Prior experience leading large, multi-stakeholder regional or enterprise projects
Any combination of education and experience providing an equivalent background
Certified Professional Coder (CPC) strongly preferred
Experience reviewing clinical criteria and assigning codes according to coding guidance highly preferred
Ability to work in-office 1–2 days per week
Must reside within a reasonable commuting distance from a posting location unless an accommodation is granted
Ability to work 8:00 am–5:00 pm EST, Monday to Friday
Additional hours may be necessary based on company needs

Benefits

Comp & perks

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
401(k) match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Hybrid work flexibility