Program Manager – Electronic Visit Verification

Anticipated End Date:

2025-06-07

Position Title:

Program Manager – Electronic Visit Verification

Job Description:

Program Manager – Electronic Visit Verification

Sign On Bonus Eligible

Locations: Overland Park, Kansas or Topeka, Kansas

In Office Expectation: 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. Alternate locations may be considered.

The Program Manager – Electronic Visit Verification (EVV) is responsible for the development and ongoing management of one or more multi-year external client facing programs within a business unit. Program managers typically support business strategies through an integrated portfolio of external client facing projects or initiatives. A program manager may have responsibility for a piece of a larger enterprise/regional external client facing program.

How You Will Make an Impact

Primary duties may include, but are not limited to:

• Manages and coordinates the development, approval, implementation and compliance of on-going external client facing programs.

• Works collaboratively with internal departments-Physical Health Utilization Management, Long Term Services and Supports Utilization Management, Claims, and Operations.

• Provides subject matter expertise in response to day-to-day external client facing business issues.

• Research applicable subject matter practices and remains aware of industry trends.

• Manages external client facing relationships and partners with corporate and regional business areas.

• Coordinates training related to external client facing program; develops program success measures and performs periodic assessments of program success.

• Collaborates with service coordination and provider relations teams to ensure compliance with EVV regulations.

• Monitors day-to-day EVV operations and supports issue resolution in collaboration with local IT Account Manager and Operations Lead.

• Monitors daily file performance, reviews EVV response files, and leads reconciliation of rejected authorization records from Vendor; this includes reviewing daily Healthy Blue fallout report to ensure errors are resolved and all authorizations are accounted for.

• Acts as Healthy Blue’s EVV Lead to external State Partners and Vendors, attending EVV Town Halls and other EVV-related State meetings to stay abreast on trends, upcoming changes, and provider concerns.

Minimum Qualifications:

• Requires a BA/BS and minimum of 5 years external client facing experience in program/project management; or any combination of education and experience, which would provide an equivalent background.

Preferred skills, qualifications and experiences:

• Project management certification preferred.

• JIRA knowledge and experience is strongly preferred.

• FACETS knowledge and experience is strongly preferred.

• Managed Care organization experience is strongly preferred.

• Knowledge and experience in Kansas EVV system and understands what is needed to meet requirements is preferred.

• Understands how a claims system works in conjunction with the State of Kansas EVV Aggregator to support seamless claims adjudication preferred.

• Knowledge of standard billing practices and how to support providers with troubleshooting claims issues for EVV-required billing codes preferred.

• Comfortable with reviewing and trending EVV data from both internal sources as well as the State sponsored EVV aggregator preferred.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

BSP > Program/Project

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 me