Solution Director, SMI Total Cost of Care - Military Veterans

Carelon's portfolio of businesses has collectively delivered high-impact results for over 150 years.  With capabilities spanning pharmacy, behavioral health, complex care delivery, medical benefits management, payment integrity, palliative care, advocacy, research, digital platforms, and operations and technology services, Carelon is a leader in the healthcare services space.  

The Solutions Management Director will lead the execution of the product strategy and drive performance management for the Serious Mental Illness (SMI) total cost of care product across all markets. This innovative and unique whole health risk solution spans 100% of the total cost of care for our patients, integrating utilization management, care management, pharmacy management, and data analytics—working closely with networks and providers to enhance outcomes. Reporting to the Staff VP and General Manager of Carelon's SMI Product, this Director will focus on achieving financial growth and meeting gross margin targets, while managing product key performance metrics through root cause analysis, developing and implementing action plans, and ensuring continuous improvement.  Strong relationship management is essential, as this Director will collaborate with functional leaders across clinical operations, network, IT, pharmacy, quality, and digital to drive successful outcomes and support the commercialization of this multifaceted solution.  This position can work in a hybrid way from any US corporate location, and the internal-facing job title is Business Strategy Plan Director.

How you will make an impact:

• Supports business strategy development, including expansion of product.  

• Solution Performance management, including risks and solution development, across all functional areas. 

• Vendor and partnership management and implementation.

• Offers support for executive deck preparation, storytelling and organizational communications.

• Leads projects end to end across the program team and critical growth partners. 

• Understands all aspects of the product line and business, and partners with executive leadership to define strategy and successful criteria for the future.

• Translates strategy into defined tactics, programs/projects priorities, and timelines and ensures alignment and attainment of enterprises strategic plans to turn strategy into reality.

• Documents strategic priorities such as external environment and reports on customer insight research initiatives.

• Builds and leverages relationships to provide innovative solutions to complex business problems.  Manages matrix partners across compliance, legal, sales, client management, engineering, architecture, finance, product, etc.

• Proposes opportunities to improve results based on continuous needs assessment.

• Responsible for the development implementation and monitoring of solution, focusing on operational and KPI metrics, ensuring TAT (Turnaround Time) and SLAs (Service Level Agreements) are being managed appropriately.

Requires a BA/BS degree in a related field and a minimum of 10 years of related experience including prior leadership experience and 3 to 5 year strategic planning; or any combination of education and experience, which would provide an equivalent background.

Highly preferred skills and experiences:

-Experience leading projects and driving project execution in a large, matrixed enterprise. 

-Healthcare experience as a solution manager, product manager, or the business owner of a product. Experience working cross-functionally with digital and IT, helping develop business requirements needed for products, translating that into technical requirements, and then driving the implementation. 

-Operational experience managing product performance, dashboards/insights, product strategy, and product strategy. 

-Behavioral health, serious mental illness (SMI), or substance use disorder (SUD) product and/or clinical experience.

-Risk arrangement programs and/or whole health total cost of care solutions.

-Experience in a dynamic startup environment

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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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.