Elevance Health

Nurse Practitioner

• Collaborate with company physicians, patients’ other physicians and providers, and family members to develop complex plans of care
• Provide clinical and non-clinical support to patients
• Provide urgent and primary care through telephone and tele-video modalities
• Develop and implement clinical plans of care for adult patients with chronic and complex conditions
• Gather patient histories, perform physical exams, obtain diagnostics as needed, and develop treatment plans
• Identify and close gaps in care
• Address patients’ and families’ physical and psychosocial needs with interdisciplinary team support
• Educate patients and families about medications, side effects, illness progression, diet and nutrition, adherence, and crisis prevention
• Coordinate care and resources with clinical team members, physicians, and medical providers
• Maintain patient medical records and documentation in accordance with regulations and company standards
• Participate in continuing education as required by state and certifying body
• Prescribe medication as permitted by state prescribing authority

Nurse Practitioner – 100% Virtual

General

• Conduct service coordination functions for a defined caseload of individuals in specialized programs
• Facilitate the Person Centered Planning process with supported individuals
• Conduct assessments and develop comprehensive Person Centered Support Plans and backup plans
• Interface with Medical Directors and participate in interdisciplinary care rounds
• Engage members’ circles of support and manage physical health, behavioral health, and LTSS needs
• Perform face-to-face program assessments using tools with pre-defined questions
• Apply motivational interviewing techniques for evaluations, coordination, and management of waiver and behavioral or physical health needs
• Identify members with potential clinical healthcare needs and coordinate cases as the single point of contact with clinical healthcare management and interdisciplinary teams
• Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities
• Document short- and long-term service and support goals with members’ chosen care teams
• Identify members who may benefit from alternative service levels or waiver programs
• Mentor, provide subject matter expertise, or serve as preceptor for new staff
• Assist with formal training and process improvement initiatives
• Submit utilization and authorization requests with supporting care-plan documentation
• Report critical incidents to internal and external parties, including state and county agencies
• Assist with appeals, fair hearings, member grievances, and state audits

LTSS Service Coordinator – Clark County, Floyd County

Consultant

• Establish relationships with functional teams across the organization
• Handle complex, high-priority business questions and issues
• Assist in building new client relationships
• Lead and implement business improvement initiatives to enhance organizational effectiveness and profitability
• Coach project teams on tools for assessing people, process, and systems performance
• Partner with regional Six Sigma and TQM process improvement initiatives
• Leverage common initiatives, eliminate duplication, and ensure enterprise alignment
• Establish and monitor metrics and measurements
• Teach managers to use tools to manage their environments and sustain improvement gains
• Establish cross-organizational relationships that generate engagements
• Develop adopted practices that improve communications, results measurement, and engagement management
• Travel to worksites and other locations as necessary

Senior Business Improvement Consultant

• Provide primary and acute care through telephone and tele-video modalities
• Develop and implement clinical plans of care for adult patients with chronic and complex conditions
• Gather patient histories, physical examinations, and diagnostics as needed
• Develop and implement treatment plans based on patient goals and current conditions
• Identify and close gaps in care
• Address patients’ and families’ physical and psychosocial needs with interdisciplinary team support
• Educate patients and families about medications, side effects, illness progression, diet, nutrition, adherence, and crisis prevention
• Coordinate care with company physicians, other physicians, medical providers, patients, families, and clinical team members
• Maintain patient medical records and documentation in accordance with regulations and company policy
• Participate in continuing education
• Prescribe medication as permitted by state authority
• Collaborate to develop complex care plans aligned with patient health status, goals, and values
• Provide clinical and non-clinical support to patients receiving home and community-based services

Manager

• Perform case management telephonically within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs
• Use appropriate screening criteria knowledge and clinical judgment to assess member needs
• Conduct assessments to identify individual needs
• Develop care plans addressing objectives and goals identified during assessment
• Monitor and evaluate care plan effectiveness and modify plans as needed
• Support member access to appropriate, quality, and cost-effective care
• Coordinate with internal and external resources to meet members’ identified needs
• Collaborate with providers
• Complete required in-person training sessions while working virtually full-time

Behavioral Health Case Manager I

Vice President

• Provide operational leadership to implement Elevance Health’s Information Security strategic vision
• Develop and execute information security and business resiliency policies, strategies, and processes
• Direct specialized internal and external resources
• Translate strategic vision into measurable execution and integrated delivery across cybersecurity disciplines
• Manage technology solutions and adherence to in-scope security controls
• Oversee security technology infrastructure and data security hygiene
• Monitor and remediate internal and external risks
• Collaborate with Enterprise Technology Associate Services on technology integrations
• Lead cross-functional execution across Identity and Access Management, Security Technology Services, Data Protection, Cyber Security Threat Management, Cloud Security, Security Architecture, and Artificial Intelligence
• Work with senior leadership, Legal, Audit and Risk Management, customers, regulators, industry committee representatives, business stakeholders, IT stakeholders, and vendors
• Report directly to the VP Chief Information Security Officer

Staff VP, Deputy CISO

Pharmacist

• Provide leadership and guidance to the Special Investigations Unit team
• Investigate, collect, research, and analyze billing data to detect fraudulent, abusive, or wasteful activities and practices
• Assist the team manager with Special Investigations Unit administration and operations
• Coordinate and conduct pharmacy case reviews for quality assurance, investigative sufficiency, and case data management
• Direct day-to-day operations as assigned by management
• Train team members and analyze data using appropriate system tools to detect fraudulent, abusive, or wasteful payments
• Prepare statistical and financial analyses and reports documenting findings
• Maintain up-to-date case files for management review
• Prepare final reports and notification-of-findings letters for providers and legal counsel
• Create and present settlement offers for provider issues for management and/or legal approval
• Communicate findings orally and in writing to internal and external customers
• Recommend policies and procedures to prevent loss of company assets
• Prepare and deliver training to internal and external entities
• Develop and maintain relationships with federal, state, and local law enforcement and regulatory agencies
• Represent the Company in court proceedings regarding research findings
• Guide investigators and SIU staff in developing criminal and recovery cases
• Lead SIU projects and initiatives

Investigator Lead – Pharmacy

• Perform care management within the scope of licensure for members with complex and chronic care needs
• Assess, develop, implement, coordinate, monitor, and evaluate care plans across the care continuum
• Perform duties telephonically or on-site, such as hospital discharge planning
• Ensure member access to services appropriate to health needs
• Conduct assessments and create care management plans addressing identified objectives and goals
• Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements
• Coordinate internal and external resources to meet identified needs
• Monitor and evaluate care plan effectiveness and modify plans as necessary
• Interface with Medical Directors and Physician Advisors on care management treatment plans
• Negotiate reimbursement rates, as applicable
• Assist with provider, claims, or service issue resolution
• Assist with developing utilization and care management policies and procedures

Nurse Case Manager II

• Conduct service coordination functions for a defined caseload of individuals in specialized programs
• Facilitate the Person Centered Planning process with supported individuals
• Conduct assessments and develop comprehensive Person Centered Support Plans and backup plans
• Interface with Medical Directors and participate in interdisciplinary care rounds
• Engage members’ support circles and manage physical health, behavioral health, and LTSS needs
• Perform face-to-face program assessments using predefined tools and motivational interviewing techniques
• Identify members with potential clinical healthcare needs and coordinate cases with clinical healthcare management and interdisciplinary teams
• Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities
• Document members’ short- and long-term service and support goals with their chosen care teams
• Identify members who may benefit from alternative service levels or waiver programs
• Mentor, train, or serve as subject matter expert or preceptor for new staff
• Participate in process improvement initiatives
• Submit utilization and authorization requests with supporting care-plan documentation
• Report critical incidents to internal and external parties, including state and county agencies
• Assist with appeals, fair hearings, member grievances, and state audits

LTSS Service Coordinator – Case Manager

• Consult on and leverage health promotion and healthy lifestyle behaviors for employers, consultants and consumers
• Win new business, retain accounts and grow membership across all lines of business
• Collaborate with Culture, Well-being and Community Engagement teams to develop multi-year health promotion plans and engagement strategies
• Strengthen positive workplace culture and community connections
• Conduct customer worksite wellness assessments
• Provide qualitative and quantitative feedback
• Plan and facilitate on-site or virtual employee well-being events
• Serve as well-being ambassador for the region
• Design customized health promotion solutions for employer and consultant communities
• Optimize wellness dollars to promote member engagement and position wellness as a competitive differentiator with clients
• Operate primarily in the field, traveling to client sites or designated locations
• Attend the office three days a week
• Travel 15–20% to Palmdale, El Segundo, San Diego, and other northern California sites

Health Promotion Manager

Solutions Engineer

• Lead development and architecture of agentic AI solutions, including orchestration, tool integration, and reusable enterprise patterns
• Use AI coding tools daily or weekly, such as GitHub Copilot, Cursor, Claude Code, ChatGPT, and Codex-style agents
• Define and implement model evaluation frameworks covering quality, accuracy, safety, and performance metrics
• Guide teams on continuous improvement of AI-enabled engineering
• Apply responsible AI, data privacy, and secure handling of sensitive information
• Improve AI output quality through prompt optimization and model tuning
• Maintain customer relationships to determine business requirements
• Lead requirements-gathering meetings and review designs with the business
• Anticipate technical change and keep company technology ahead of the curve
• Understand architecture, scaling limits, and reliability limits for major business areas
• Own the change request process and coordinate with other teams
• Develop and own the list of final enhancements
• Define application scope and objectives and supervise technical and functional specifications
• Perform technical design reviews and code reviews
• Ensure unit testing and system testing are completed according to plan
• Deliver application technology solutions and data information planning
• Participate in multi-year technology strategy for critical business areas
• Partner with technical and non-technical stakeholders on long-term technology infrastructure direction
• Create architecture and anticipate future technology needs
• Lead internal discussions on technology direction and drive consensus
• Coordinate and manage on-call support and own system monitoring
• Review and monitor initiatives for end-to-end impact and coordination
• Participate in review and decision-making for enterprise solutions

AI Solutions Engineer – Lead

• Serve as the strategic and operational partner to specialty pharmacy leadership
• Translate organizational priorities into actionable clinical initiatives
• Own project timelines, deliverables, and critical milestones
• Identify risks and implement mitigation strategies
• Lead development, implementation, and oversight of clinical programs
• Coordinate enterprise-wide specialty pharmacy initiatives across clinical operations, provider engagement, payer strategy, quality, compliance, and technology teams
• Monitor and evaluate specialty pharmacy performance metrics
• Improve quality, patient experience, access to therapy, and operational efficiency
• Lead governance processes, executive reporting, and performance reviews
• Develop evidence-based clinical strategies and care models with medical, pharmacy, and population health leaders
• Liaise between leadership and frontline clinical teams
• Lead cross-functional problem solving for operational, clinical, and regulatory issues
• Facilitate executive decision-making through data analysis, business cases, and strategic recommendations
• Sponsor initiatives focused on health outcomes, patient engagement, medication safety, and equitable access
• Establish outcome measurement frameworks and demonstrate clinical and economic value
• Support payer, manufacturer, and provider partnership strategies
• Represent specialty pharmacy leadership in executive committees, enterprise workgroups, and external stakeholder engagements
• Lead special projects and enterprise transformation efforts
• Ensure clinical operations align with organizational goals, regulations, and industry best practices
• Coordinate daily scheduling issues and standards of practice
• Provide work direction, training, and development of associates
• Contribute input to performance reviews
• Lead technical process updates with other functional areas
• Chair project teams
• Lead creation and filling of staffing models based on business needs

Lead Pharmacist

• Perform care management within the scope of licensure for members with complex and chronic care needs
• Assess, develop, implement, coordinate, monitor, and evaluate care plans
• Optimize member healthcare across the care continuum
• Ensure member access to services appropriate to their health needs
• Conduct assessments to identify individual needs and care management objectives and goals
• Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements
• Coordinate internal and external resources to meet identified needs
• Monitor and evaluate care plan effectiveness and modify plans as necessary
• Interface with Medical Directors and Physician Advisors on care management treatment plans
• Negotiate reimbursement rates, as applicable
• Assist with provider, claims, or service issues
• Perform duties telephonically or on-site, such as at hospitals for discharge planning

Nurse Case Manager – 100% Virtual

• Manage care for members with complex and chronic care needs within the scope of licensure
• Assess members and develop, implement, coordinate, monitor, and evaluate care plans
• Ensure member access to services appropriate to health needs
• Conduct assessments to identify individual needs and care management objectives
• Facilitate authorizations and referrals within benefit structures or through extra-contractual arrangements
• Coordinate internal and external resources
• Monitor care plan effectiveness and modify plans as necessary
• Interface with Medical Directors and Physician Advisors on care management treatment plans
• Negotiate reimbursement rates as applicable
• Assist with provider, claims, and service issue problem-solving
• Assist with developing utilization and care management policies and procedures
• Perform duties telephonically

• Provide exercise guidance to disease management members
• Collaborate with nurse case managers in managing disease management health goals of members
• Implement primary care physicians’ exercise recommendations
• Provide safe and effective exercise instruction and guidance
• Provide member health coaching, education, assessment and support of behavioral changes
• Promote self-management of chronic conditions
• Provide members with education materials related specifically to member score condition

Nurse Practitioner – 100% Virtual

LTSS Service Coordinator – Clark County, Floyd County

Senior Business Improvement Consultant

Nurse Practitioner

Behavioral Health Case Manager I

Staff VP, Deputy CISO

Investigator Lead – Pharmacy

Nurse Case Manager II

LTSS Service Coordinator – Case Manager

Health Promotion Manager

AI Solutions Engineer – Lead

Lead Pharmacist

Nurse Case Manager – 100% Virtual

Nurse Case Manager II

Exercise Physiologist