Qureos Mentor

Elevance Health

<div>
 
 Pharmacy Technician II &ndash; CarelonRx Call Center
 
 
 
 
 Hours: 12-8:30 pm EST
 
 
 
 
 Location:
 
 This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.
 
 
 
 Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
 
 
 
 
 CarelonRx
 
 is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member&rsquo;s health.
 
 
 The
 
 Clinical Pharmacy Care Center (CPCC)
 
 is a clinical pharmacy call center that services Medicare, Medicaid, and the Commercial member populations. The members we reach out to have been identified as having gaps in care. Our goal is to close those gaps through education and assistance.
 
 
 The
 
 Pharmacy Technician II
 
 will be responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues.
 
 
 
 How You Will Make An Impact
 
 
 
 <ul>
 <li>
 Verifies member information and inputs data for the pharmacists.
 </li>
 <li>
 Educates members about prescriptions and medication resources or assistance programs.
 </li>
 <li>
 Educates members on medication adherence-related topics to align closely with STARs Ratings and HEDIS quality measures.
 </li>
 <li>
 Assists members with scheduling their preventive test/screenings and medication resources or assistance programs.
 </li>
 <li>
 Makes outreach to members or providers to close care gaps and improve outcomes.
 
 
 </li>
 </ul>
 
 Minimum Requirements
 
 
 
 <ul>
 <li>
 Requires H.S. diploma or equivalent and minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
 </li>
 <li>
 Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.
 
 
 </li>
 </ul>
 
 Preferred Skills, Capabilities And Experiences
 
 
 
 <ul>
 <li>
 Experience communicating with and supporting Medicare members preferred.
 </li>
 <li>
 Call center experience with high call volumes preferred.
 </li>
 <li>
 Experience in discussing medication adherence preferred.
 </li>
 <li>
 Proficient in computer systems and multitasking preferred.
 </li>
 <li>
 Patient care experience preferred.
 
 
 </li>
 </ul>
 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.
 
 
 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 &ndash; 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.
 
 
 How We Work
 
 
 At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
 
 
 We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
 
 
 Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
 
 
 The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
 
 
 Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
 
 
 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
 
 
 Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
</div>

Pharmacy Tech II - CarelonRx Call Center

<div>Job ID: JP00046649
Anticipated Start Date: July 27,2026
Please note this is the target date and is subject to change. BCForward will send official notice ahead of a confirmed start date. 
Pay Range: (PLEASE DELETE THIS FULL SECTION BEFORE POSTING AFTER UPDATING PAY TRANSPARENCY SECTION WITH UNDERLINED SECTION BELOW)
[California, Colorado, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New York, Ohio, Rhode Island, Vermont, Washington, and Washington DC]
The pay range is the range BCForward in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. 
BCForward Benefits:
BCForward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.
The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. This does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.). 
Elevance Health is a health company dedicated to improving lives and communities &ndash; 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. 
Please Note: If this is not a straight backfill, please consult with your HR Business Partner prior to posting/using this job.
Responsible for managing the end-to-end hiring process while ensuring superior candidate experience for technical roles within the information technology, data analytics and digital space.
Primary duties may include but are not limited to:
<ul><li>Advising and consulting the business on the right fit and overseeing the sourcing, screening, and interview processes in order to acquire the best talent to meet business needs. Functions as the talent champion that can energetically sell the role and the company brand to candidates.
</li><li>Manages end-to-end talent acquisition processes ensuring superior candidate experience and shepherding candidates and business representatives through the process.
</li><li>Collaborates with human resource partners and talent acquisition program managers.
</li><li>Serve as a single point of contact for candidates and hiring managers throughout recruiting process.
</li><li>Provides consultation to hiring managers on talent needs and recommends candidate slate. Develops sourcing strategies in conjunction with hiring manager and Sourcing Center. Directs sourcers in conducting sourcing and resume screening processes.
</li><li>Directs coordinators in supporting seamless candidate process.
</li><li>Conducts phone screens for candidates.
</li><li>Works with talent acquisition support team to ensure hiring managers can conduct interviews.
</li><li>Aggregates evaluation feedback for final hiring decision.
</li><li>Negotiates and closes offers and communicates decisions with candidates.
</li><li>Effectively utilizes available technologies to maximize efficiency, quality, and productivity. 
</li></ul> 
Requirements:<ul><li>
Requires a BA degree in HR related field and/or marketing or communications field and a minimum of 3 years of talent acquisition experience; or any combination of education and experience which would provide an equivalent background.
</li><li>Experience in sourcing, screening, and interviewing candidates required.</li></ul> 
Job Type: Contract w/ possible extension. 
 
Additional Details:<ul><li>
Experience utilizing current talent acquisition digital technologies strongly preferred.
</li><li>Ability to interface with candidates in an engaging and persuasive manner; ability to partner with, advise, and influence hiring managers in a consultative manner to foster long-term relationships strongly preferred.
</li><li>Experience with both corporate (in-house) and third-party recruiting strongly preferred. In-depth knowledge of the TA landscape in health insurance industry strongly preferred. Master's degree; Professional HR / TA Certification(s) strongly preferred.</li></ul> 
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. 
About BCForward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally. 
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work. 
BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. 
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process. 
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.
<div>Pay Rate Range
29.34 - 54.09 USD hourly
</div><div>Additional Notes
The pay range is the range BCForward in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations.
</div><div>Benefits Information
BCForward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.
The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. This does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).</div></div>

Tech Recruiter (contract)

<div>Job ID:JP00046488
Anticipated Start Date: 06/08/2026
Please note this is the target date and is subject to change. BCForward will send official notice ahead of a confirmed start date.
Elevance Health is a health company dedicated to improving lives and communities &ndash; 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.
Responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics. Typically provides technical assistance to lower level staff.
Primary duties may include, but are not limited to:<ul><li>
Creates and maintains databases to track business performance.
</li><li>Analyzes data and summarizes performance using summary statistical procedures.
</li><li>Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.
</li><li>Creates and publishes periodic reports, as well as any necessary ad hoc reports.
</li><li>May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.
</li><li>May make recommendations based upon data analysis</li></ul>
Requirements:<ul><li>
Requires a BS/BA degree in related field and a minimum of 3 years data analysis or related experience; or any combination of education and experience which would provide an equivalent background.
</li><li>Experience with relational databases and knowledge of query tools and statistical software is strongly preferred.
</li><li>Ability to manipulate large sets of data is strongly preferred.
</li><li>Proficient in Microsoft Excel and skilled in data analysis.</li><li>
Data Analysis &amp; Reporting Tools: Excel, Python, Tableau, SaaS</li><li>
Programming &amp; Automation: Python, Bash, Perl, Git</li><li>
Data &amp; Computational Practices: data quality assurance, validation workflows 
Time management - 3,000 data files - in process of automating/modernizing reports</li><li>
Strong analytical, organizational and problem solving skills are strongly preferred.</li></ul>
Job Type: Contract Opportunity only
Additional Details:<ul><li>
100% remote.
</li><li>Possibility of extension to 6months contract.</li></ul>
Time Schedule:<ul><li>
8:30am-5pm(Mon - Fri)</li></ul>
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
About BCForward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.
<div>Pay Rate Range
31.45 - 69.88 USD hourly
</div><div>Additional Notes
The pay range is the range BCForward in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations.
</div><div>Benefits Information
BCForward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.
The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. This does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).</div></div>

Bus Info Analyst Sr (contract)

<div>Business Information Analyst II - HEDIS Quality Analytics
Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
PLEASE NOTE: This position is not eligible for current or future visa sponsorship.
Carelon, a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center&mdash;connecting physical, behavioral, social, and pharmacy services, along with clinical expertise, research, operations, and advanced technology to help care work better, together. 
 
Among us are specialty-care physicians, nurse practitioners, pharmacists, engineers, data scientists, and other dedicated and caring health professionals. While our roles may differ, our purpose is shared: to make a positive impact on whole health.
The Business Information Analyst II will be responsible for analyzing, reporting and developing recommendations on data related to multiple, varied business metrics.
How You Will Make an Impact:<ul><li>
Creates and maintains databases to track business performance.</li><li>
Analyzes data and summarizes performance using summary statistical procedures.</li><li>
Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.</li><li>
Creates and publishes periodic reports, makes necessary recommendations, and develops ad hoc reports as needed.</li><li>
May require taking business issues and devising the best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.</li></ul>
Minimum Requirements:<ul><li>
Requires a BS/BA degree in a related field and a minimum of 2 years related operational and/or data analysis experience, experience in database structures, and standard query and reporting tools; or any combination of education and experience which would provide an equivalent background.</li></ul>
Preferred Skills, Capabilities, &amp; Experiences:<ul><li>
Understanding multiple data sources and formats and utilizing multiple data systems to analyze HEDIS results is preferred.</li><li>
Experience with relational databases and knowledge of query tools and statistical software is strongly preferred including SQL.</li><li>
Strong MS Office command. Power BI skills experience a plus.</li><li>
Experience with Jira, ServiceNow, or other ticketing systems preferred.</li><li>
Alteryx and Python experience a plus.</li></ul> 

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 &ndash; 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.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.</div>

Business Information Analyst II - HEDIS Quality Analytics

<div>Seeking Nurse Practitioners licensed in the following state: New Jersey AND Must have an active RN Compact license
Location: Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.
Work Shift: Monday &ndash; Friday; 8:00am &ndash; 5:00pm EST; On call rotation required
The Advance Practice Provider, Nurse Practitioner is responsible for collaborating with company physicians, the patient&rsquo;s other physicians and providers, and their family members to develop complex plans of care in accordance with the patient&rsquo;s health status and overall goals and values. Provides clinical and non-clinical support to patients.
How you will make an impact:
<ul><li>Provides primary and urgent health care via telephone and tele video modalities to patients who receive home and community-based services through state Medicaid programs, dual eligible members and other membership as assigned by our MCO partners.</li><li>
Develops and implements clinical plans of care for adult patients facing chronic and complex conditions (e.g., co-morbid medical and mental health diagnoses, limited personal resources, chronic medical conditions.).</li><li>
Gathers history and physical exam and diagnostics as needed, and then develops and implements treatment plans given the patient&rsquo;s goals of care and current conditions.</li><li>
Identifies and closes gaps in care.</li><li>
Meets the patient&rsquo;s and family&rsquo;s physical and psychosocial needs with support and input from the company&rsquo;s inter-disciplinary team.</li><li>
Educates patients and families about medication usage, side effects, illness progression, diet and nutrition, medical adherence and crisis anticipation and prevention.</li><li>
Maintains contact with other clinical team members, patients&rsquo; other physicians and patients&rsquo; other medical providers to coordinate optimal care and resources for the patient and his or her family in a timely basis and consistent with state regulations and company health standards and policy.</li><li>
Maintains patient medical records and medical documentation consistent with state regulations and company standards and policy.</li><li>
Participates in continuing education as required by state and certifying body.</li><li>
Prescribes medication as permitted by state prescribing authority.</li></ul>
Minimum requirements:
<ul><li>Requires an MS in Nursing.</li><li>
Requires an active national NP certification.</li><li>
Requires valid, current, active and unrestricted Family or Adult Nurse Practitioner (NP) license in the state of New Jersey.
</li><li>Requires valid, current, active, RN Compact license.</li><li>
Experience working with Electronic Medical Records (EMR) required.</li><li>
Requires 2+ years of experience in managing complex care cases.
</li></ul>Preferred skills, capabilities, and experiences:
<ul><li>Possession of DEA registration or eligibility preferred.</li><li>
Active Medicaid number in the state of New Jersey is highly preferred.</li><li>
Experience in managing complex care cases for developmental disabilities and chronically ill patients strongly preferred</li></ul>
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $110,080.00 to $189,888.00
Locations: New Jersey
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
<ul><li>The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company&rsquo;s sole discretion, consistent with the law.</li></ul> 

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 &ndash; 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.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.</div>

Nurse Practitioner 100% Virtual, CareBridge

<div>Seeking Nurse Practitioners licensed in the following state: Ohio AND Must have an active RN Compact license
Location: Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.
Work Shift: Monday &ndash; Friday; 8:00am &ndash; 5:00pm EST; On call rotation required
The CareBridge Advance Practice Provider, Nurse Practitioner is responsible for collaborating with company physicians, the patient&rsquo;s other physicians and providers, and their family members to develop complex plans of care in accordance with the patient&rsquo;s health status and overall goals and values. Provides clinical and non-clinical support to patients.
How you will make an impact:<ul><li>
Provides primary and urgent health care via telephone and tele video modalities to patients who receive home and community-based services through state Medicaid programs, dual eligible members and other membership as assigned by our MCO partners.</li><li>
Develops and implements clinical plans of care for adult patients facing chronic and complex conditions (e.g., co-morbid medical and mental health diagnoses, limited personal resources, chronic medical conditions.).</li><li>
Gathers history and physical exam and diagnostics as needed, and then develops and implements treatment plans given the patient&rsquo;s goals of care and current conditions.</li><li>
Identifies and closes gaps in care.</li><li>
Meets the patient&rsquo;s and family&rsquo;s physical and psychosocial needs with support and input from the company&rsquo;s inter-disciplinary team.</li><li>
Educates patients and families about medication usage, side effects, illness progression, diet and nutrition, medical adherence and crisis anticipation and prevention.</li><li>
Maintains contact with other clinical team members, patients&rsquo; other physicians and patients&rsquo; other medical providers to coordinate optimal care and resources for the patient and his or her family in a timely basis and consistent with state regulations and company health standards and policy.</li><li>
Maintains patient medical records and medical documentation consistent with state regulations and company standards and policy.</li><li>
Participates in continuing education as required by state and certifying body.</li><li>
Prescribes medication as permitted by state prescribing authority.</li></ul>
Minimum requirements:<ul><li>
Requires an MS in Nursing.</li><li>
Requires an active national NP certification.</li><li>
Requires valid, current, active and unrestricted Family or Adult Nurse Practitioner (NP) license in the state of Ohio.
</li><li>Requires valid, current, active, RN Compact license.</li><li>
Experience working with Electronic Medical Records (EMR) required.</li><li>
Requires 2+ years of experience in managing complex care cases.
</li></ul>Preferred skills, capabilities, and experiences:<ul><li>
Active Medicaid number in the state of Ohio is highly preferred.</li><li>
Possession of DEA registration or eligibility preferred.</li><li>
Experience in managing complex care cases for developmental disabilities and chronically ill patients strongly preferred</li></ul>
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $110,080 to $165,120
Locations: Columbus, OH, Cleveland, OH
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.<ul><li>The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company&rsquo;s sole discretion, consistent with the law.</li></ul> 

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 &ndash; 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.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.</div>

<div>
 
 Nurse Appeals- Licensed Nurse
 
 
 
 
 Location:
 
 Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
 
 
 Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
 
 
 
 Hours
 
 : The work schedule for this position is Tuesday through Saturday with Sunday rotation. Business hours are 8 am to 8 pm EST, and the selected candidate must be able to work an 8-hour shift between those hours, including holidays on a rotational basis.
 
 
 The
 
 Nurse Appeals
 
 is responsible for investigating and processing and medical necessity appeals requests from members and providers.
 
 
 
 How You Will Make An Impact
 
 
 
 <ul>
 <li>
 Conducts investigations and reviews of member and provider medical necessity appeals.
 </li>
 <li>
 Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity.
 </li>
 <li>
 Extrapolates and summarizes medical information for medical director, consultants and other external review.
 </li>
 <li>
 Prepares recommendations to either uphold or deny appeal and forwards to Medical Director for approval.
 </li>
 <li>
 Ensures that appeals and grievances are resolved timely to meet regulatory timeframes.
 </li>
 <li>
 Documents and logs appeal/grievance information on relevant tracking systems and mainframe systems.
 </li>
 <li>
 Generates written correspondence to providers, members, and regulatory entities.
 </li>
 <li>
 Utilizes leadership skills and serves as a subject matter expert for appeals/grievances/quality of care issues and is a resource for clinical and non clinical team members in expediting the resolution of outstanding issues.
 
 
 </li>
 </ul>
 
 Minimum Requirements
 
 
 
 <ul>
 <li>
 Requires a HS diploma or equivalent and a minimum of 2 years of experience in a managed care healthcare setting; or any combination of education and experience, which would provide an equivalent background. Current active unrestricted RN license to practice as a health professional within the scope of licensure in applicable state(s) or territory of the United States required.
 
 
 </li>
 </ul>
 
 Preferred Skills, Capabilities And Experiences
 
 
 
 <ul>
 <li>
 AS or BS in Nursing preferred.
 </li>
 <li>
 Three to five years of clinical experience as a Registered Nurse strongly preferred.
 </li>
 <li>
 Have a current active unrestricted RN license to practice nursing within the scope of licensure in applicable state(s) or territory of the United States strongly preferred.
 </li>
 <li>
 Have two years in a managed care healthcare setting - reviewing medical records, investigation, and/or processing appeals within a managed care setting; or any combination of education and experience, which would provide an equivalent background strongly preferred.
 </li>
 <li>
 Experienced researching Medicare clinical guidelines: NCD, LCD; Medicare Benefit Policy and Milliman Care Guidelines is preferred.
 </li>
 <li>
 Experience reviewing claims and researching CPT codes or ICD-9 codes is preferred.
 </li>
 <li>
 Experience with Facets, Macess, and ACMP is preferred.
 
 
 </li>
 </ul>
 For candidates working in person or virtually in the below locations, the salary* range for this specific position is $72,492 to $108,738
 
 
 
 Locations: Latham, New York
 
 
 
 In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
 
 
 <ul>
 <li>
 The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company&rsquo;s sole discretion, consistent with the law.
 
 
 </li>
 </ul>
 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 &ndash; 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.
 
 
 How We Work
 
 
 At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
 
 
 We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
 
 
 Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
 
 
 The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
 
 
 Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
 
 
 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
</div>

Nurse Appeals

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