Anticipated End Date:2026-09-02
Position Title:Grievance and Appeals and State Fair Hearing Program Business Change Manager, Senior
Job Description:Grievance and Appeals and State Fair Hearing Program Business Change Manager, SeniorLocation: 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.
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 accommodation is granted as required by law.
The
Grievance and Appeals Program Business Change Manager, Senior will be responsible for managing Provider Grievances, Provider Appeals, and Provider 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.
How you will make an impact:- 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 8 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 Provider Grievances, Appeals, administrative hearings, or other legal processes 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 as a legal assistant or paralegal or comparable education or employment experience is strongly preferred.
- 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
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.
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.
