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Elevance Health
Grievance and Appeals and State Fair Hearing Program, Business Change ManagerElevance Health • Topeka, KS, United States
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Grievance and Appeals and State Fair Hearing Program, Business Change Manager

Grievance and Appeals and State Fair Hearing Program, Business Change Manager

Elevance Health • Topeka, KS, United States
20 days ago
Job type
  • Full-time
Job description

Grievance And Appeals And State Fair Hearing Program, Business Change Manager

Location: Overland Park or Topeka, Kansas. This role is required to be domiciled in the state of Kansas.

Hybrid 1: 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.

The Grievance And Appeals And State Fair Hearing Program, Business Change Manager will be responsible for managing Member Grievances, Member Appeals, and Member State Fair Hearings for the Kansas Health Plan.

Responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals.

Primary duties to include, but are not limited to:

  • Identifies potential issues, project change, and scope.
  • Leads efforts to identify best practices.
  • Identifies impacted parties, business partners, and resources required.
  • Develops and designs processes and systems that support business needs.
  • Designs methods for integrating function and process.
  • Conducts cost/benefit analyses.
  • Builds support for business change throughout the business unit.
  • Ensures State Fair Hearing notices and case documentation are accurate and complete
  • Supports all State Fair Hearing materials timely submission
  • Ensures all Member and Provider cases are appropriately tracked and reported, and records remain audit-ready

Minimum Requirements:

  • Requires a BA/BS in a related field and minimum of 5 years process improvement, business change or project related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • Experience with Member Grievances, Appeals, administrative hearings, or other legal processes strongly preferred.
  • Experience as a legal assistant or paralegal or comparable education or employment experience is strongly preferred.
  • Experience with accurate, complete, and timely regulatory documentation and submission is strongly preferred.
  • Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • Experience in successfully developing and managing projects with fairly significant operating budget and knowledge of process redesign strongly preferred.

Job Level: Non-Management Exempt

Workshift: Job Family: BSP > Business Support

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Grievance and Appeals and State Fair Hearing Program, Business Change Manager • Topeka, KS, United States

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