Payment Integrity Program Manager Jobs in Ohio (NOW HIRING)

Anticipated End Date:

2026-09-11

Position Title:

Business Change Advisor - Carelon Payment Integrity

Job Description:

Business Change Advisor - Carelon Payment Integrity

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.

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-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 care providers, engineers, data scientists, and other dedicated professionalsdetermined to recover, eliminate and prevent unnecessary medical-expense spending.

The Business Change Advisor will be responsible for assisting the management within the business unit and the organization in bridging the gap between the current and desired business performance levels and balancing short-term business needs with long-term perspectives on success to ensure that our change journey produces desired results.

How you will make an impact:

• Helps build and support the company's change network andPI-related process enhancements.
• Providesdata entry and documentation support for Payment Integrity execution rolesto assist business units in implementing and tracking key activities. Communicates information from a variety of sources through newsletters, dashboards, and presentations, includingclaims accuracy insights and PI program updates.
• Promotes benefits of function within region as well as throughout the company, particularly efforts that contribute toimproving payment accuracy and reducing errors.
• Helps build and support the company's change network.
• Communicates information from a variety of sources through newsletters, dashboards and presentations.
• Promotes benefits of function within region as well as throughout the company.

Minimum Requirements:

• Requires a BA/BS and minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Expertise in preparing executive-facing PowerPoint presentations, synthesizing complex information into clear visuals, and supporting leadership decision-making through polished presentation materials.
• Experience supportingPayment Integrity, Claims, or Healthcare Operations functions.
• Strongdata entry accuracy, documentation management, and ability to track PI execution activities.
• Familiarity withclaims processing, overpayment identification, audit workflows, or financial accuracy processes.
• Ability to interpret and communicatePayment Integrity metrics, trends, and operational updates.
• Proficiency with reporting or workflow tools (e.g.,Excel, SharePoint, Tableau, or internal PI platforms).
• Strong attention to detail with the ability to managemultiple data sources, queues, or workstreams.
• Experience collaborating with cross-functional teams such as Claims, SIU, Clinical Review, and Operations.
• Demonstrated ability to supportprocess improvements, change initiatives, and performance optimization efforts.

Job Level:

Non-Management Exempt

Workshift:

1st Shift (United States of America)

Job Family:

BSP > Business Support

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.

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. 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.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.