Elevance Health
Manager, Medical Director – Transformation Initiatives
Elevance Health, Indianapolis, Indiana, us, 46262
Manager, Medical Director – Transformation Initiatives
The
Manager, Medical Director – Transformation Initiatives
role at Elevance Health. Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. Alternate locations may be considered. Per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Overview: The
Manager, Medical Director
will serve as a clinical and strategic advisor to enterprise transformation programs spanning affordability, medical cost management, modernization, and growth initiatives. This role provides medical and clinical leadership to ensure that large-scale technology, operations, and product initiatives align with clinical best practices, regulatory requirements, and the organization’s goals of affordability, quality, and innovation. The Medical Director will work closely with engineering, product, operations, and business leaders to shape transformation strategies, assess clinical and financial impacts, and guide implementation of initiatives that impact providers, members, and clients across the healthcare ecosystem. How You Will Make An Impact
Strategic Clinical Leadership Provide clinical insight and medical guidance across multiple enterprise transformation initiatives, including: Medical Cost Management HealthOS and enterprise data platforms Real-time Decisioning & Analytics (RDA) Cost of Care / Payment Integrity Care Management / Utilization Management (CM/UM) Modernization Provider Networking & Modernization Value-Based Care and Carelon Risk models Carelon Research & Data Commercialization Client Information Insights and CDIP/Consumer Experience Advise on Teradata/SAS migration and retirement, ensuring data modernization supports clinical and operational needs. Translate complex clinical and regulatory requirements into actionable technical and operational strategies. Program & Initiative Support Partner with SVRO (Strategic Value Realization Office) and enterprise transformation leaders to assess clinical and medical cost implications of strategic initiatives. Evaluate program designs for alignment with quality, safety, and evidence-based clinical practice. Guide affordability-focused programs with a balance of cost containment, care quality, and provider/member experience. Collaboration & Influence Collaborate with engineering, analytics, and product teams to ensure platforms such as HealthOS and RDA incorporate clinical intelligence and deliver actionable insights. Advise Carelon Research and Data Commercialization teams on ethical and clinically appropriate use of healthcare data. Partner with Provider Network leaders to shape modernization strategies that drive value-based outcomes and affordability. Serve as a clinical voice in modernization of CM/UM platforms, ensuring alignment with regulatory mandates and member engagement expectations. Regulatory & Compliance Oversight Ensure compliance with clinical, accreditation, and regulatory standards across transformation programs. Support interpretation of federal/state mandates and advise on clinical implementation strategies. Minimum Requirements
Requires MD or DO and Board certification approved by one of the following certifying boards where applicable to duties performed: American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). Active unrestricted medical license to practice medicine or a health profession. Locational requirement: unless expressly allowed by state or federal law, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. Minimum of 10 years of clinical experience, or an equivalent background through a combination of education and experience. Preferred Qualifications
5+ years of clinical practice experience, with transition into payer, managed care, or healthcare leadership preferred. Experience advising medical cost management, utilization management, payment integrity, or provider performance programs preferred. Strong understanding of healthcare data systems (claims, EHR, analytics platforms) and payer operations preferred. Proven ability to influence cross-functional teams and guide complex, enterprise-level initiatives. Prior leadership in a payer, health plan, or healthcare innovation organization preferred. Familiarity with enterprise platforms such as Teradata, SAS, or cloud-based data ecosystems. Experience in value-based care, population health, and care management program design preferred. Understanding of research and data commercialization within healthcare. Ability to communicate effectively with technical, clinical, and executive stakeholders. Salary & Location: The salary range for this position at the posting location is $291,900 to $500,400. Locations include California, Colorado, District of Columbia (Washington, DC), Illinois, New Jersey, New York, Washington State. The salary offered is based on geographic location, work experience, education, and skill level, and is subject to change. Elevance Health provides a comprehensive benefits package and equity considerations where applicable. The company is an equal opportunity employer. About Elevance Health
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, seeking leaders at all levels who are passionate about making an impact on our members and the communities we serve. We offer a range of market-competitive total rewards, including health benefits, 401(k) with match, stock purchase plan, and wellness programs. Elevance Health operates in a Hybrid Workforce Strategy. Specific onsite expectations will be discussed during the hiring process. Elevance Health is an Equal Employment Opportunity employer. Applicants with arrest or conviction records will be considered in accordance with applicable laws. accommodations in the application process are available upon request. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. Note: The content above reflects the duties and requirements as described in the posting. This description does not create a contract of employment and is subject to change at any time.
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The
Manager, Medical Director – Transformation Initiatives
role at Elevance Health. Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. Alternate locations may be considered. Per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Overview: The
Manager, Medical Director
will serve as a clinical and strategic advisor to enterprise transformation programs spanning affordability, medical cost management, modernization, and growth initiatives. This role provides medical and clinical leadership to ensure that large-scale technology, operations, and product initiatives align with clinical best practices, regulatory requirements, and the organization’s goals of affordability, quality, and innovation. The Medical Director will work closely with engineering, product, operations, and business leaders to shape transformation strategies, assess clinical and financial impacts, and guide implementation of initiatives that impact providers, members, and clients across the healthcare ecosystem. How You Will Make An Impact
Strategic Clinical Leadership Provide clinical insight and medical guidance across multiple enterprise transformation initiatives, including: Medical Cost Management HealthOS and enterprise data platforms Real-time Decisioning & Analytics (RDA) Cost of Care / Payment Integrity Care Management / Utilization Management (CM/UM) Modernization Provider Networking & Modernization Value-Based Care and Carelon Risk models Carelon Research & Data Commercialization Client Information Insights and CDIP/Consumer Experience Advise on Teradata/SAS migration and retirement, ensuring data modernization supports clinical and operational needs. Translate complex clinical and regulatory requirements into actionable technical and operational strategies. Program & Initiative Support Partner with SVRO (Strategic Value Realization Office) and enterprise transformation leaders to assess clinical and medical cost implications of strategic initiatives. Evaluate program designs for alignment with quality, safety, and evidence-based clinical practice. Guide affordability-focused programs with a balance of cost containment, care quality, and provider/member experience. Collaboration & Influence Collaborate with engineering, analytics, and product teams to ensure platforms such as HealthOS and RDA incorporate clinical intelligence and deliver actionable insights. Advise Carelon Research and Data Commercialization teams on ethical and clinically appropriate use of healthcare data. Partner with Provider Network leaders to shape modernization strategies that drive value-based outcomes and affordability. Serve as a clinical voice in modernization of CM/UM platforms, ensuring alignment with regulatory mandates and member engagement expectations. Regulatory & Compliance Oversight Ensure compliance with clinical, accreditation, and regulatory standards across transformation programs. Support interpretation of federal/state mandates and advise on clinical implementation strategies. Minimum Requirements
Requires MD or DO and Board certification approved by one of the following certifying boards where applicable to duties performed: American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). Active unrestricted medical license to practice medicine or a health profession. Locational requirement: unless expressly allowed by state or federal law, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. Minimum of 10 years of clinical experience, or an equivalent background through a combination of education and experience. Preferred Qualifications
5+ years of clinical practice experience, with transition into payer, managed care, or healthcare leadership preferred. Experience advising medical cost management, utilization management, payment integrity, or provider performance programs preferred. Strong understanding of healthcare data systems (claims, EHR, analytics platforms) and payer operations preferred. Proven ability to influence cross-functional teams and guide complex, enterprise-level initiatives. Prior leadership in a payer, health plan, or healthcare innovation organization preferred. Familiarity with enterprise platforms such as Teradata, SAS, or cloud-based data ecosystems. Experience in value-based care, population health, and care management program design preferred. Understanding of research and data commercialization within healthcare. Ability to communicate effectively with technical, clinical, and executive stakeholders. Salary & Location: The salary range for this position at the posting location is $291,900 to $500,400. Locations include California, Colorado, District of Columbia (Washington, DC), Illinois, New Jersey, New York, Washington State. The salary offered is based on geographic location, work experience, education, and skill level, and is subject to change. Elevance Health provides a comprehensive benefits package and equity considerations where applicable. The company is an equal opportunity employer. About Elevance Health
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, seeking leaders at all levels who are passionate about making an impact on our members and the communities we serve. We offer a range of market-competitive total rewards, including health benefits, 401(k) with match, stock purchase plan, and wellness programs. Elevance Health operates in a Hybrid Workforce Strategy. Specific onsite expectations will be discussed during the hiring process. Elevance Health is an Equal Employment Opportunity employer. Applicants with arrest or conviction records will be considered in accordance with applicable laws. accommodations in the application process are available upon request. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. Note: The content above reflects the duties and requirements as described in the posting. This description does not create a contract of employment and is subject to change at any time.
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