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Staff VP – Digital Claims Operations
Elevance Health. Develop, communicate, and execute the digital claims strategy and transformation roadmap .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in leading digital claims operations and transformation initiatives, with a strong focus on AI, automation, and analytics. Proven ability to manage cross-functional teams, budgets, and complex projects while ensuring regulatory compliance and driving continuous improvement.
Highest-signal resume keywords
Digital Claims Strategy DevelopmentAI And Automation LeadershipClaims Operations ManagementCross-Functional Project CoordinationRegulatory Compliance Expertise
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims Operations ManagementDigital TransformationAI ImplementationProcess OptimizationAnalyticsBudget ManagementSolution DeliveryPerformance Metrics MonitoringWorkflow RedesignChange Management
Soft Skills
LeadershipTeam ManagementCommunicationAnalytical AbilitiesStakeholder Engagement
Tools & Technologies
Claims AnalyticsDigital CapabilitiesAutomation ToolsTechnology IntegrationData Management
Certifications & Qualifications
BA/BS Degree In Information TechnologyAdvanced Degree In Business Or Related Field (Preferred)
Industry Keywords
Healthcare EnterpriseActuarial ReservingCost Of CarePayment IntegrityRegulatory Compliance
About the role
Key responsibilities & impact- Develop, communicate, and execute the digital claims strategy and transformation roadmap
- Translate company objectives 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 claims processes, reduce manual work, improve decision quality, and strengthen member and provider service
- Serve as the claims analytics domain lead
- Support enterprise actuarial reserving and Cost of Care initiatives
- Lead the intersection of claims operations, analytics, and technology
- 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
- Lead end-to-end solution delivery from opportunity definition through implementation, adoption, monitoring, and optimization
- Coordinate cross-departmental projects and manage dependencies, decision rights, and accountability
- Manage budgets and resource priorities
- Design and implement pilots for strategies, workflows, analytics, AI, automation, and innovative technologies
- Define pilot hypotheses, measures, controls, and scale decisions
- Monitor performance metrics and drive productivity, service quality, processing accuracy, and continuous improvement
- Collaborate with IT on technology upgrades, implementations, integration, and operating readiness
- Engage stakeholders and communicate priorities, progress, risks, and outcomes
- Promote responsible AI and automation governance
- Ensure regulatory compliance, privacy, security, audit readiness, and risk management
- Lead, mentor, hire, train, coach, counsel, and evaluate a high-performance team
- Build capabilities across claims operations, analytics, digital product leadership, process optimization, AI, automation, and change execution
Requirements
What you’ll need- BA/BS degree in Information Technology, Computer Science or related field of study
- Minimum of 15 years of claims operations management and digital transformation experience
- Proven leadership and team management skills
- Strong analytical abilities
- Strong communication abilities
- In-depth understanding of industry regulations and compliance standards
- Advanced degree in business, technology, analytics, healthcare administration, or a related field (preferred)
- 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
- Experience integrating claims operations, analytics, technology, product, provider data management and configuration, and change management into a cohesive operating model
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
- Professional and personal growth opportunities