Senior Manager Solutions - Claims

ABOUT ELEVANCE HEALTH

Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler. It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states

.
A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux, President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this lis

t.
ABOUT CARE

LON
Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare sys

tem.Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as provid

ers.Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective, and effici

ent.
OUR MISSION & V

ALUES
Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting

More.Our Values: Leadership | Community | Integrity | Agility | Div

ersity
JOB P

OSITION
The Senior Manager- Solutions position is responsible to drive Quality engineering process standardization and adherence across organization. The role has to enable the delivery team for quality rigor, predictability, analysis of leading/lagging metric insights and bring down cost of quality. Role also acts as reviewer for all the process standardization and adherence across organization and certify that projects are executed as per s

tandards
JOB RESPO

• NSIBILITYBuild Best-in class Quality Management System (QMS) from the internal and Industry best practices (Process, Template, Checklist, SOP, guidelines across BO, Tech, Agile, W
• aterfall)Responsible to manage Quality Management System (QMS) and its currency to industry trends and Carelon Req
• uirementsCoach the delivery team in first time right quality culture, adoption of QMS practices and champion
• trainingsEnsure code quality, coding standards and peer reviews are followed in all the
• projectsEnsure Delivery tools are adopted across all the
• projectsProvide SME expertise in metrics definition, tracking and insights at tower and In
• dia levelDevelop best-in class trends and analytics and help define organizational quality goals f
• or futureEnsure Risk Management across all projects and highlight tower/organization level Risks and mi
• tigationsEnsure Root Cause analysis (RCA) are completed, and corrective action are implemented in both Tech
• /BO TowerDrive Knowledge management process (lesson learnt, best practices, any best-in class process/templates) across org
• anizationEnforce knowledge codification, sharing and refresh across org
• anizationLead organization level Continuous Improvement (CI) in
• itiativesReport and governance on risks, project need attention, metrics deviations and potential es
• calationsConduct quarterly quality Spot-check to verify QMS adoption, best practices and recognize for best
• projectsExperience in tools like Minitab and C
• onfluenceExperience in independently driving QMS development and
• roll-outExperience in running large Delivery Governan

ce forums
QUA

• LIFICATIONBE/

B.Tech/MCA

• 
  EXPERIENCEPreferred Minimum experienc
• e: 20 yearsProficiency in the full spectrum of claims domain is
• necessary.A deep understanding of the entire claims lifecycle, from origination to processing and payment,
• is crucial.A solid understanding of both the IT and Operations aspects is

essential.
SKILLS AND

• COMPETENCIESAbility to communicate at all levels with clarity and precision both written and verbally, g
• ood listenerAbility to multi-task and switch context to changing priorities in a highly dynamic
• environmentExcellent presentation and reporting skills to executive lev
• el audiencesGood Strategic thinking and problem-so
• lving skillsMulti-project management/portfolio managemen

t experience
THE CA

RELON PROMISE
Aligning with our brand belief of limitless minds are our biggest asset, we offer a world of limitless opportunities to o

ur associates.It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for

an associate.This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling

of belonging.

• 
  LIFE @ CARELONExtensive focus on learning
• and developmentAn inspiring culture built on innovation, creativi
• ty, and freedomHoli
• stic well-beingComprehensive range of rewards a
• nd recognitionsCompetitive health and medical ins
• urance coverageBest-in-class amenities
• and workspacesPolicies designed with associate

s at the center
EQUAL OPPO

RTUNITY EMPLOYER
Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other

characteristics.
Reason

able AccommodationOur inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the div

erse ways we work.If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommoda

tion Request Form.
Disclaimer: Offered designa