Jobs at Elevance Health

Serve as statistical lead for complex clinical research: design studies, develop sample size calculations and statistical analysis plans, oversee analyses and teams, mentor statisticians, contribute to grants and publications, present findings to stakeholders, and support business development for externally funded research programs.

Provide telephonic crisis intervention, safety screenings and assessments for callers to the Massachusetts Behavioral Health Helpline. Triage risk, develop action plans, document interactions, coordinate referrals and follow-up, and connect callers to resources while ensuring regulatory compliance.

Provide care coordination and peer-support services to members, engage families, deliver psychiatric discharge planning education, collaborate on discharge and service transitions, advocate for members, and maintain contact with individuals and providers to monitor recovery progress.

Lead PBM product strategy and execution for clinically driven solutions across commercial and government segments. Partner with cross-functional teams to develop formulary, utilization management, and specialty pharmacy product bundles, ensure regulatory compliance, monitor market trends, drive P&L outcomes, and support go-to-market and client-facing activities.

Perform complex Medicare cost report desk reviews and audits, prepare work papers per Government Auditing Standards and CMS requirements, analyze financial data, review exception requests and appeals, mentor junior staff, and support special projects. May supervise and perform supervisory reviews and manage Medicare cost report appeals and settlements.

Provide telephonic crisis intervention and de-escalation, screen and assess callers, develop and monitor care plans, coordinate internal/external resources, support non-clinical call takers, lead shifts in manager absence, monitor call volumes and staff availability, and participate in cross-functional projects to improve operations and member outcomes.