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Position Title Benefits & Claims - Lead EBA - BO-13783-44874 - Growth - JR151302 Job Family MBR > Membership & Enrollment Rep Shift Job Description: Job Title Lead EBA Requirement Type Full-Time Employee Job Location Gurugram Requirement Level Lead EBA Hiring Manager Senior Manager Primary Skill US Healthcare Knowledge Business CBS/EBA Configuration Skill Category Generic 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 Testing and Benefit configuration is an added advantage. JOB RESPONSIBILITY Lead EBA (IND) Will Be Responsible For The Following Minimum 8-12 years' Experience in US Health Care .Preferably experience in Benefit configuration 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) Forecasting & Capacity planning Assess capacity shortages and requirement for overtime. Ensures individuals and the team meet their performance objectives. Act as a liaison with the various internal & external business partners 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 & flexible for all shifts Timely management of bottom quartiles performers Partner connects People management Employee Retention/Employee engagement Experience in JIRA EWM applications Team player in organizational activities Quality Management – Experience in Quality metrics/Tools, RCA & CAPA QUALIFICATION Bachelors’ or Masters’ degree Experience 8 to 12 years of experience in US healthcare process Skills And Competencies Strong US Healthcare expertise Experience in Claims Testing and Benefit Configuration People Management & Stakeholder/Partner Management Day-to-day operational management & Delivering results Good vocal and written communication skills Good PowerPoint and presentation skills Excellent reporting and excel skills Capacity planning & Forecasting Conflict Management Decision-making Process improvements & Project Management Relationship Building Planning and Organizing Adaptability/Change Management Efficient Problem-Solving Skills 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 * Job Type Full time Show more Show less
