Benefit Configuration - Associate Benefits Analyst

Carelon

Hyderabad, Telangana, India

Posted: a year ago

JOB DESCRIPTION Job Title Associate Benefits Analyst (IND) Requirement Type Full-Time Employee Job Location Hyderabad Requirement Level Associate Benefits Analyst (IND) Hiring Manager Team Lead Primary Skill US Healthcare Knowledge Business CBS Configuration Skill Category BO ABOUT ELEVANCE HEALTH Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler.  It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states. A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux , President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list. ABOUT CARELON Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system. Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers. Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective and efficient. OUR MISSION & VALUES Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More. Our Values: Leadership | Community | Integrity | Agility | Diversity JOB POSITION Carelon Global Solutions India is seeking Associate Benefits Analyst who have good US healthcare knowledge. Preferably Benefits Configuration -WPD Benefit Coding/Auto Adjudication set up. JOB RESPONSIBILITY Associate Benefits Analyst (IND) will be responsible for the following: 2 to 4 years of experience in US Healthcare and in Benefit Configuration - WPD Benefit coding / Auto Adjudication Set up processes. Drive continuous improvement for Quality and Delivery Ability to complete the assigned tasks on time, Understand the SLAs and ensure they are met or bet. Ability to coordinate with the Leads and Onshore in work prioritization and able to track and report self and PAs work. Good Analytical and problem-solving skills Excellent US Healthcare knowledge in Benefits coding and validation Willing to work in any shifts. Excellent communication skills and experience in working with US clients directly. QUALIFICATION Bachelors’ or Masters’ degree EXPERIENCE 2 to 4 years of experience in US healthcare process SKILLS AND COMPETENCIES Good Analytical and problem-solving skills Excellent US Healthcare knowledge in Benefits coding and validation Willing to work in any shifts. Excellent communication skills and experience in working with US clients directly THE CARELON PROMISE Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates. It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate. This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging. LIFE @ CARELON Extensive focus on learning and development An inspiring culture built on innovation, creativity, and freedom. Holistic well-being Comprehensive range of rewards and recognitions Competitive health and medical insurance coverage Best-in-class amenities and workspaces Policies designed with associates at the center EQUAL OPPORTUNITY EMPLOYER Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. Reasonable Accommodation Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work. If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form. Disclaimer : Offered designation titles differ*

ORMB QA Tech Lead

Carelon

Bangalore Urban, Karnataka, India

Posted: a year ago

JOB DESCRIPTION 1) Should have strong Knowledge on TFM process 2) Atleast 6+ years of of ORMB experience 3) Strong knowledge on account setups, Pricing and Rating process 4) Should be sound in Billing and Payments, Adjustments and Accruals 5) Should have knowledge on GL Processing 6) Should have very good knowledge on SQL DML commands 7) Should be good using in Unix commands 8) Should have strong knowledge on SDLC process 9) Should have experience on test plan and test strategy process 10) Jira/HP ALM/any Test management tools knowledge 11) Should be a team player and at times should be individual contributor 12) Good to have ETL testing knowledge  13) Knowledge on Automation testing/tools is added advantage. 14) Must have experience in Leading/Coaching a team (Atleast 8 members). 15) Should be an assertive person and have good convincing and negotiation skills. 16) Experience in preparing precise reports/metrics and sharing it with business and IT leadership. Extra Job Content This is an example of some common job content that can be shown at the bottom of every job description. It is added in the CMS and then shown on every job. It can be used to supplement the job content that comes from the ATS.

Benefit Coding & Testing - Lead EBA

Carelon

Bangalore Urban, Karnataka, India

Posted: a year ago

JOB DESCRIPTION Job Title Lead EBA (IND) Requirement Type Full-Time Employee Job Location Bangalore – Bagmane Requirement Level Lead EBA (IND) Hiring Manager Assistant Manager/Manager Primary Skill US Healthcare Knowledge & People Management Business CBS Configuration Skill Category BO ABOUT ELEVANCE HEALTH Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler.  It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states. A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux , President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list. ABOUT CARELON Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system. Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers. Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective and efficient. OUR MISSION & VALUES Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More. Our Values: Leadership | Community | Integrity | Agility | Diversity JOB POSITION Carelon Global Solutions India is seeking Lead EBA who have good US healthcare knowledge & People management skills. Preferably experience in claims, Benefit coding, testing & Configuration & Claims Testing is an added advantage. JOB RESPONSIBILITY Lead EBA (IND) will be responsible for the following: Minimum 8-10 years' Experience in US Health Care. Experience in claims, Benefit coding, testing & Configuration & Claims Testing is an added advantage. Managing the day-to-day operations Responsible for meeting daily, weekly, monthly internal metrics (AHT, Utilization, Internal & External Quality, TAT, Productivity) Capacity planning Assess capacity shortages and requirement for overtime Ensures individuals and the team meet their performance objectives Act as a liaison with the client for any process updates, additional scope, training Responsible for ensuring SOPs and Training Materials are up-to-date Review capacity requirements on an ongoing basis and initiate hiring, redeployment requests as required. Additional focus required for Open Enrollment capacity planning Operational management including driving  KRA's and feedback Conduct timely performance appraisal for associates Excellent knowledge on Excel & PowerPoint. Assists in Function level reporting Inter-team collaboration with other leaders providing assistance and seeking support wherever required Active participation on Process improvements & Project Management. Willing to work in US shifts. Timely management of bottom quartiles performers Partner connect People Engagement QUALIFICATION Bachelors’ or Masters’ degree EXPERIENCE 8 to 10 years of experience in US healthcare process SKILLS AND COMPETENCIES Managing the day-to-day operations Responsible for meeting daily, weekly, monthly internal metrics (AHT, Utilization, Internal & External Quality, TAT, Productivity) Capacity planning Assess capacity shortages and requirement for overtime Ensures individuals and the team meet their performance objectives Act as a liaison with the client for any process updates, additional scope, training Responsible for ensuring SOPs and Training Materials are up-to-date Review capacity requirements on an ongoing basis and initiate hiring, redeployment requests as required. Additional focus required for Open Enrollment capacity planning Operational management including driving  KRA's and feedback Conduct timely performance appraisal for associates Excellent knowledge on Excel & PowerPoint. Assists in Function level reporting Inter-team collaboration with other leaders providing assistance and seeking support wherever required Active participation on Process improvements & Project Management. Willing to work in US shifts. Timely management of bottom quartiles performers Partner connect People Engagement THE CARELON PROMISE Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates. It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate. This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging. LIFE @ CARELON Extensive focus on learning and development An inspiring culture built on innovation, creativity, and freedom Holistic well-being Comprehensive range of rewards and recognitions Competitive health and medical insurance coverage Best-in-class amenities and workspaces Policies designed with associates at the center EQUAL OPPORTUNITY EMPLOYER Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. Reasonable Accommodation Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work. If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form. Disclaimer : Offered designation titles differ*

Server Hardware Configuration Engineer

Hewlett Packard Enterprise

Bangalore Urban, Karnataka, India

Posted: a year ago

What you’ll do: Work closely with the platform development & Marketing team to understand the  offering strategy, compatibility, Work in the OTT application tool to setup the dependency rule tagged to the appropriate options. Product and options relationship (compatibility) in the OTT Internal Tool Working with the Product management team on the BTO model Setup in OTT tool that will be used to compare the CTO and BTO offerings This role requires working in the OTT tool to build the product offering structure for the NPI/Sustaining platforms This Role requires updating the OTT tool to build the options compatibility with servers is Compute, HPC and Storage portfolio Closely engage with other CTO Engineers to understand the option offerings and strategy that is implemented in other platforms. Manages the changes that comes up later in the product development and relay those compatibility changes in the OTT application. This will help the downstream systems to have this changes adapted. Develop expertise on OTT Application & processes and CTO engineering processes. Participate regularly in management reviews and provide management reports on weekly or monthly basis Identify and drive the process improvements that adds value to the deliverables. Management Level Definition: Applies basic foundation of a function's principles, theories and concepts to assignments of limited scope. Uses professional concepts and theoretical knowledge acquired through specialized training, education or previous experience. Develops expertise and practical knowledge of applications within business environment. Acts as team member by providing information, analysis and recommendations in support of team efforts. Exercises independent judgment within defined parameters. What you’ll do: Work closely with the platform development & Marketing team to understand the  offering strategy, compatibility, Work in the OTT application tool to setup the dependency rule tagged to the appropriate options. Product and options relationship (compatibility) in the OTT Internal Tool Working with the Product management team on the BTO model Setup in OTT tool that will be used to compare the CTO and BTO offerings This role requires working in the OTT tool to build the product offering structure for the NPI/Sustaining platforms This Role requires updating the OTT tool to build the options compatibility with servers is Compute, HPC and Storage portfolio Closely engage with other CTO Engineers to understand the option offerings and strategy that is implemented in other platforms. Manages the changes that comes up later in the product development and relay those compatibility changes in the OTT application. This will help the downstream systems to have this changes adapted. Develop expertise on OTT Application & processes and CTO engineering processes. Participate regularly in management reviews and provide management reports on weekly or monthly basis Identify and drive the process improvements that adds value to the deliverables. Education and Experience Required: Bachelor's or Master's degree in Industrial Engineering, Manufacturing Engineering, Electrical Engineering, or equivalent. Typically 0-2 years experience Knowledge and Skills: Good analytical and problem solving skills. Basic understanding of material properties and hardware and electrical component design. Good written and verbal communication skills; mastery in English and local language. Basic understanding of server hardware components and layout of the motherboard Option hardware level ( hard drive, memory, PCIe cards, networking and storage) technology

Lead Program Management

Carelon

Hyderabad, Telangana, India

+1 more

Posted: a year ago

JOB DESCRIPTION Job Title Lead Program Mgmt Requirement Type Full-Time Employee Job Location Any Requirement Level Team Lead Hiring Manager Asst Delivery Manager Primary Skill Project Management, UI Design, UX Design Business GCIO Skill Category Super Neche ABOUT ELEVANCE HEALTH Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler.  It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states. A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux , President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list. ABOUT CARELON Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system. Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers. Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective and efficient. OUR MISSION & VALUES Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More. Our Values: Leadership | Community | Integrity | Agility | Diversity JOB POSITION We are seeking a detail-oriented and organized Project Coordinator to join our team. This role will primarily focus on coordinating and supporting various projects within our organization. The ideal candidate will have a strong background in project coordination, with the ability to effectively communicate and collaborate with stakeholders. The Project Coordinator will be responsible for project intake, client/stakeholder relations, asset management, and working with a hybrid team. JOB RESPONSIBILITY Organize & facilitate intake meetings with clients to gather initial project requirements, document necessary details, and ensure alignment of expectations. Assist Director in the planning, execution, and delivery of multiple projects, ensuring they are completed on time, within budget, and meet quality standards. Collaborate closely with clients, stakeholders, and project teams to help outline project objectives, scope, deliverables, and timelines. Monitor project progress, identify potential risks and issues, and implement proactive measures to mitigate them. Conduct regular project status meetings, providing updates to stakeholders and addressing any concerns or questions. Provide support in brand oversight, ensuring consistency with brand guidelines and industry best practices. Exceptional communication and interpersonal skills, with the ability to effectively collaborate and influence stakeholders at all levels. Establish and maintain positive relationships with clients and stakeholders, serving as a point of contact for project updates and inquiries. Coordinate client/stakeholder feedback and ensure timely incorporation into project deliverables. Assist in managing the day-to-day activities of cross-functional teams, facilitating communication and collaboration. Support asset management, including organizing and maintaining project files, version control, and asset distribution. Monitor project progress, identify potential risks and issues, and assist in implementing proactive measures to mitigate them. Assist in conducting regular project status meetings, documenting updates and addressing any concerns or questions. Support the evaluation of project performance, produce necessary reports, and assist in implementing process improvements for enhanced efficiency. Proofread content. QUALIFICATION Bachelor’s degree EXPERIENCE 7+ years of experience in a relevant field, such as project management, business administration, digital communications, advertising, or marketing (or equivalent experience in-lieu of). SKILLS AND COMPETENCIES Proven experience as a project coordinator or similar role, preferably in a fast-paced corporate environment. Strong organizational and time management skills, with the ability to handle multiple tasks and meet deadlines. Excellent communication and interpersonal skills, with the ability to collaborate effectively with diverse stakeholders. Attention to detail and problem-solving abilities. Proficient in project management software and tools. Ability to work well under pressure and adapt to changing priorities. Solid understanding of creative production tools, terminology, processes, and UI & UX, MS Office Suite (particularly PPT and Excel) Previous experience working with hybrid teams and managing external vendors or freelancers is a plus. THE CARELON PROMISE Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates. It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate. This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging. LIFE @ CARELON Extensive focus on learning and development An inspiring culture built on innovation, creativity, and freedom. Holistic well-being Comprehensive range of rewards and recognitions Competitive health and medical insurance coverage Best-in-class amenities and workspaces Policies designed with associates at the center. EQUAL OPPORTUNITY EMPLOYER Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. Reasonable Accommodation Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work. If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form. Disclaimer: Offered designation titles differ*

Pega Technical Lead

Carelon

Gurgaon, Haryana, India

+2 more

Posted: a year ago

JOB DESCRIPTION Job Title Tech Lead Requirement Type Full-Time Employee Job Location Gurugram/Hyderabad/Bengaluru Requirement Level Specialist Hiring Manager Associate Delivery Manager Primary Skill PEGA Tech Lead Business CSBD- FHPS Skill Category Super Niche ABOUT ELEVANCE HEALTH Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler.  It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states. A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux , President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list. ABOUT CARELONCARELON Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system. Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers. Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective and efficient. OUR MISSION & VALUES Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More. Our Values: Leadership | Community | Integrity | Agility | Diversity JOB POSITION Carelon Global Solutions India is seeking a  PEGA Developer who is accountable for enhancing, supporting, and managing the in-house claims processing system. JOB RESPONSIBILITY Working with other architects to explore and define how the proposed capabilities will fit into the overall solution architecture. Ability to technically manage team and their deliverables. Designing class structures, application frameworks, and data models. Reviewing deliverables within the scope of the initiatives to meet the business imperatives. Strong communication, problem-solving skill Experience and desire to work in Global offshore/onshore model. Strong track record of customer engagement and delivery success. Hands on experience with large system modernizations to Pega platform a plus Implement best practices in PEGA architecture / design / coding version 8 Hands on experience with Pega Smart Claims Engine (SCE) preferred. Experience in Health Care domain preferred. QUALIFICATION Bachelor’s or master’s degree EXPERIENCE Requires an BA/BS degree in Information Technology, Computer Science, or related field. Experience designing and developing process-based solutions or BPM (business process management) Experience in working on various rules and features like Flows, Activities, User Interface, Flow Actions, Agents, SLA, Correspondence, Security, Reports, Listeners (File, MQ), Connectors etc. Experience in full PRPC implementation cycle including enterprise Class Structure design and Rulesets design. SKILLS AND COMPETENCIES At least 8 -12 years of experience in in-depth hands-on application development experience in Pega PRPC v7.x/v8.x and Pega frameworks At least 7+ years of experience in creating requirement specifications based on Architecture/Design /Detailing of Processes Excellent object-oriented analysis and design skills and system integration skills. Should be Pega certified Senior Systems Architect CSSA or LSA THE CARELON PROMISE Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates. It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate. This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging. LIFE @ CARELON Extensive focus on learning and development An inspiring culture built on innovation, creativity, and freedom. Holistic well-being Comprehensive range of rewards and recognitions Competitive health and medical insurance coverage Best-in-class amenities and workspaces Policies designed with associates at the center. EQUAL OPPORTUNITY EMPLOYER Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. Reasonable Accommodation Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work. If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form. Disclaimer: Offered designation titles differ*

Benefits Configuration - Lead

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