Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc.

Account Advisor

The use of this job is limited to the Commercial business unit. If you believe this to be the best match for your position, please consult with your Human Resources partner prior to using this job (HRBP should work with Compensation). Responsible for partnering with sales and account associates in the growth and retention of existing accounts. Primary duties may include, but are not limited to: Builds relationships internally and externally to meet client needs and understand priorities. Manages high profile sales, claims, and benefit issues by researching, resolving and responding to accounts, members, and brokers. Conducts and facilitates meetings with clients to educate, promote, persuade, and drive opportunities for additional growth and product sales; communicates with internal partners to assist with upsells. Responds to request for proposal (“RFP”) in coordination with sales support. Collaborates with internal stakeholders to meet and exceed client expectations. Utilizes internal and external client reporting. Respond directly to client on the behalf of strategic account associates as needed. Mentors and coaches team members while acting as subject matter expert on processes. Completes projects outside the department on matters of significance with the authority to represent the department. Assists with competitive situations within assigned accounts or group market, analyzes information, and develops proposals and execution plans to management. Requires a BA/BS and a minimum of 4 years of related experience; or any combination of education and experience which would provide an equivalent background. Sales license required where necessary. Must have the ability to travel throughout California when requested.

Experience or knowledge of the below systems is a plus:

Sales Force

WGS Or Solution Central

AI Machine Learning Scientist

AI Machine Learning Scientist

Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of the following PulsePoint location. 233 S. Wacker Drive, Suite 3700, Chicago, IL 60606

Hours: Monday to Friday, 8:00 am to 5:00 pm

The AI Machine Learning Scientist will analyze and design solutions to address complex and varied business needs. Consult with business partners concerning applications and implementation of technology.

How you will make an impact:

•    Mentor and collaborate with peers.
•    Work with stakeholders and design teams to assist with data-related technical issues and support their infrastructure needs.
•    Support the development and enhancement of platform functionality for email, SMS, and mobile push channels.
•    Design and implement complex multichannel and personalized dynamic communications, offers, and campaigns for external audiences.
•    Support the ongoing maintenance and utilization of the platform through user access, providing necessary governance, and removing impediments therein.

(Ref #637547)

Minimum Requirements: 

Bachelor’s degree in Computer Science, Machine Learning, Operations Research, Statistics, Mathematics, Engineering, or related. Four (4) years of experience in related occupation(s).

Additional Requirements:

Four (4) years of experience must include:

•    Four (4) years of experience working in data science, machine learning, and/or information technology.
•    One (1) year of experience with Python to create machine learning and statistical models to assist with solution creation, development, and improvement.
•    One (1) year of experience in machine learning algorithms to build customized solutions.
•    One (1) year of experience working with SQL and data-sets of varying degrees of size and complexity including both structured and unstructured data.
•    One (1) year of experience with big data environments and distributed computing environments.

•    Must have skills listed above.

ALTERNATE EDUCATION/EXPERIENCE REQUIREMENTS: Employer will accept a Master’s degree in Computer Science, Machine Learning, Operations Research, Statistics, Mathematics, Engineering, or related, and two (2) years of experience working in data science, machine learning, and/or information technology.

AFC Field Sales & Serv Rep

Since its founding in 2008, America’s 1st Choice has generated significant membership growth by developing effective engagement programs and building strong provider relationships in the Florida market. America’s 1st Choice operates as a wholly-owned subsidiary of Elevance Health.

AFC Field Sales & Service Representative

Location: The territory for this position is Lake Marion & Sumter Counties, FL Therefore, the selected candidate must reside in one of these counties or surrounding area. This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.

The AFC Field Sales & Service Rep is responsible for meeting monthly sales goal for an assigned territory through the development and implementation of a strategic sales plan.

How you will make an impact:

• Sells and promotes Senior Services products by coordinating and delivering formal sales presentations to consumer groups  arranging private appointments in the customers homes  making outbound phone calls to prospects  managing temporary support staff and managing customer records in the automated lead tracking system according to the departments standards.
• Identifies opportunities within the territory to generate leads  in addition to those provided by the company  through building relationships with contracted medical providers  senior organizations and other community leaders and educating these groups about Senior Services products.
• Cross sells specified products from other departments.
• Provides member retention services to existing customers.
• May require extensive overnight travel  as well as evening and weekend hours.

Minimum Requirements: Requires a high school diploma and a minimum of 2 years of direct sales or marketing experience; or any combination of education and experience  which would provide an equivalent background. Requires Life & Health licensure (Florida Health 2-40 or Life & Health) if required by state law.

Preferred Skills, Capabilities & Experiences: BA/BS preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

3- Nurse Medical Mgmt I (US)

Responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards  accurately interpreting benefits and managed care products  and steering members to appropriate providers, programs or community resources. Works with medical directors in interpreting appropriateness of care and accurate claims payment. May also manage appeals for services denied. Primary duties may include, but are not limited to: Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Ensures member access to medical necessary, quality healthcare in a cost effective setting according to contract. Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process. Collaborates with providers to assess member’s needs for early identification of and proactive planning for discharge planning. Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications. Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards. Requires a HS diploma or equivalent. Requires current active valid unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States and minimum of 2 years acute care clinical experience. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position.