Position Title:
Pre Sales- Senior Manager Business Solutions- CO- GR- 39595-70129-1- JR168863
Job Family:
BUS > Business Dev/Growth
Shift:
Job Description:
Job Title
Senior Manager Business Solutions
Requirement Type
Full-Time Employee
Job Location
Hyderabad/Bengaluru/Gurugram
Requirement Level
Senior Manager
Hiring Manager
Director
Primary Skill
Pre Sales in US Healthcare market
Business
CGS Growth Partners - Commercialization
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 46 million lives across 14 states.
A regular in the Fortune 500 list, Elevance ranked 20 in 2025. Gail Boudreaux , President and CEO of Elevance has been a consistent name in the Fortune list of most powerful women and currently holds 53rd rank on this list.
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 highly skilled Senior Manager Business Solutions with expertise in developing RFP responses for IT/BPO solution proposals in US Healthcare.
- The ideal candidate will play a pivotal role in designing and implementing innovative solutions.
- The Business Solution architect should have end to end payer value chain understanding, including but not limited to plan/products, member management, provider, claims, finance and utilization management.
- He/she will be an essential part of the sales and pre-sales team, responsible for designing and presenting tailored solutions to meet the specific needs of our clients.
- The Business Solution architect will be part of commercialization-pre sales team.
- As part of the Global Commercialization Organization, the candidate will work directly with the Solution Domain Director as a business partner to develop and drive solutions across CGS capability value chain in support of our commercialization strategy.
- The candidate on one side will work with sales team for any new opportunity to understand the customer needs and pain points, on another side, candidate will work with Carelon Global solutions (CGS) delivery towers to understand what capabilities CGS has and then stich a technical and business solution curated as per customer needs and paint points.
- This role is a techno functional role and requires a deep understanding of US healthcare payer ecosystem, the ability to translate technical capabilities into business value, and the acumen to engage with clients and stakeholders effectively.
- The candidate should have led/participated in medium to large scale solution creations as part of RFP processes.
JOB RESPONSIBILITY
Solution Design
- Lead the design and development of comprehensive solutions for RFP responses, ensuring alignment with business objectives and regulatory requirements.
- Understand and translate client s business requirements into technical & functional solutions in the Healthcare BPO and IT context, with key focus on US Healthcare
- Assist the sales team by establishing technical credibility and qualifying prospects.
- Collaborate with clients to understand their business goals, workflows, and system needs to create and present custom solutions.
- Provide solutions utilize data analytics, identify trends, and provide actionable insights for transformative and continuous improvement as part of overall solutiong design
- Own end-to-end RFP response on Functional, Technical and Commercial solution, including leadership of a global Proposal team of Delivery SME-s, Bid Manager, Technical Leads, Pricing, Legal, Creative Services, to strategize, design, document and submit our solution to client.
- Work with sales/presales, delivery, transition, finance and other support functions within organisation to create a compelling solution and value propostion.
- Identify and mitigate solution risks and increase solution effectiveness and efficiency
Support Pre-Sales and Sales Activities
- Lead RFP / RFI / RFQ response for clients, building a unique value proposition which combines AI, Automation and Client-centric service design, powered by Data and Analytics
- Engage in technical discussions with potential clients, addressing questions, concerns, and technical challenges.
- Conduct feasibility studies, cost-benefit analysis, and ROI calculations to support the sales process.
- Act as a technical liaison between customers, pre-sales, and product managers.
- Conduct Gap Analysis of organization services offerings and solutions and identify potential partners for collaborating to leverage solutions.
- Streamline client responses to be consistent and aligned to CGS s Solutioning and Bidding framework, as necessary.
Healthcare payer domain expertise
- Provide expert insights into the end-to-end healthcare payer eco system , but not limited to plan/products, member management, provider, claims, finance and utilization management.
- Provide expert inputs for application development and management and data services related solutioning as and when required basis the RFP scope.
- Client oral presentations : Prepare and deliver oral presentations for prospective clients showcasing the proposed solution and best practices
Thought leadership
- Provide thought leadership and contribute to the development of thought papers/ whitepapers, case studies, and technical documentation.
- Keep up to date with the latest trends and technologies in Healthcare, HealthTech, claims processing systems, industry trends in Business Process Outsourcing, to design solutions that keep our clients ahead of competition in healthcare transformation and service excellence.
Continuous value addition
- Communicate with internal stakeholders on a continuous basis during the lifecycle of a proposal.
- Review overall solution performance based on BAU operations reporting and identify variances and potential causes.
- Understand and document all historic and in-flight transformation initiatives and translate them into opportunities for new customers.
- Identify best practices that can be introduced across clients.
- Provide input to business partners regarding benefits of product /service and analytics.
- Explains timelines and measures of success for implementing these product /service.
- Work together with development teams to consult on enhancements to existing product and development of new solutions based on analytics.
- Review business partner specifications and/or modifications for contracted products and services.
- Analyze business partner data for QA and identification of opportunities for business partners to utilize products and services to improve plan performance.
- Maintain working knowledge of all current systems, products and services and basic understanding of future system and product development plans to allow appropriate level of communication with business partner.
Stakeholder Collaboration
- Work closely with internal and external stakeholders, including healthcare providers, payers, and IT teams, to gather requirements and ensure seamless integration of solutions.
- Work with CGS internal functions across Sales, Delivery, Technology, Legal, Finance, Compliance, etc, to design best-fit solutions that are viable and deliverable.
Estimations & Pricing
Provide leadership around dynamic Estimation and Pricing models that best meet client expectations.
Solution playbook creation
Bring in industry best practices, well verse with various solution architect frameworks, (SAM/TAM) and Industry standard operational metrices.
Process Optimization
Lead consultative partnership with clients to map as-is operations, Process Maturity Modelling, Due-diligence Assessment, Customer Journey Mapping and identify process improvement / automation opportunities that result in reducing operational cost and enhancing end-customer experience.
Regulatory Compliance
Ensure all solutions comply with relevant healthcare regulations and standards, such as HIPAA and ICD-10.
Documentation
Create detailed documentation, including solution design specifications, process flows, and user manuals.
Training and Support
Mentor and train the team members part of pre-sales team and delivery tower SMEs on solution design, industry best practices and how to create customer centric propsoals.
QUALIFICATION
- Bachelor s degree in Healthcare Management, Information Technology, Business Administration, or a related field. Advanced degree preferred.
- Strong understanding of healthcare regulations, coding standards (ICD-10, CPT), and industry best practices. HIPAA, PAHM, FAHM certifications wil be highly desirable.
- Certifications like TOGAF, Cloud Certified Solution Architect, Agile & Design Thinking Practitioner etc., can be an advantage.
EXPERIENCE
- Minimum of 15+ years of experience in healthcare claims processing and solution design.
- Significant experience in developing, selling, and delivering healthcare IT and BPO solutions.
- 10+ years experience in a pre-sales or technical sales role is highly desirable.
- Well Versed in Estimation, Staffing and Transition models with deal sizes > $1 Million ACV
- Should have in-depth understanding of the delivery operation, and all processes necessary to deliver the solution
- Demonstrated relevant experience defining, developing, and executing customer services strategies, operations and action plans
- RFP/RFI contributions : Candidate should have history of leading/contribution to large and complex RFP/RFIs. The candidate must maintain focus and exhibit versatility as a collaborative team member, particularly in high-pressure situations.
- US healthcare domian kowledge : Exhibits strong strategic thinking and adept people management skills. Possesses a comprehensive understanding of healthcare domains, including claims, members, and providers
- Global exposure : Proven experience in engaging with global stakeholders across different geographical regions.
- C-level engagement : Ability to engage with client CXO level and senior leadership, Ability to get buy-ins from internal senior leadership
- Business Intelligence : Understanding of data analytics and business intelligence in a healthcare context.
- Project Management : Experience with project management and Agile methodologies.
SKILLS AND COMPETENCIES
- Must have : Proficiency in healthcare management systems, data analytics
- tools, and process automation technologies.
- Expertise in healthcare Application devlipemnet, Data services.
- Good to have : Working knowledge across one of more following functions of the payer value chain (membership, provider lifecycle management, contact center, medical management)
- Familiarity with cloud, mobile, and analytics technologies.
- Ability to communicate at all levels with clarity and precision both written and verbally, good listener.
- Good stakeholder management skills
- Ability to multi-task and switch context to changing priorities in a highly dynamic environment.
- Ability to quickly understand technical concepts and explain them to customer audiences
- Ability to navigate a highly matrixed organization effectively.
- Sound business and data technologies acumen.
- Focused and versatile individual contributor who is comfortable to deliver under pressure.
- Demonstrated, applied experience establishing and delivering complex projects.
- Excellent presentation and reporting skills to executive level audience.
- Good Strategic thinking and 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
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 tiltes differ*
Job Type:
Full time
