Revenue Cycle Management (RCM) Consultant - CarelonRx

About the role

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 members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If

Responsibilities

• Develop and maintain enterprise or function-level revenue cycle standards, policies, procedures, and governance practices to support consistent execution and compliance.
• Evaluate revenue cycle operations across teams and sites, identify structural improvement opportunities, and recommend reengineered workflows and operating models.
• Advise leaders on automation opportunities across eligibility, authorization, claim edits, denial prevention, appeals, payment posting, underpayment detection, and work queue routing.
• Lead complex cross-functional initiatives involving process standardization, technology enablement, performance management, and organizational change.
• Design rollout plans, audit-ready controls, KPI dashboards, and governance cadences to ensure improvements are sustained post-implementation.
• Serve as a subject matter expert for RCM best practices, payer rules, revenue leakage risk, and scalable operating design.

Requirements

• In depth revenue cycle experience, in pharmacy preferred.
• Experience in consulting, shared services, multi-site healthcare, or enterprise transformation environments.
• Exposure to automation tools, workflow orchestration, analytics platforms, or AI-enabled RCM solutions.
• Experience supporting policy standardization and operational redesign across multiple business units or functions.
• Job Level:
• Non-Management Exempt
• Workshift:
• 1st Shift (United States of America)
• Job Family:
• AFA > Financial Reporting, Planning & Analysis
• 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.

Benefits

Additional Information

Anticipated End Date: 2026-06-12 Position Title: Revenue Cycle Management (RCM) Consultant - CarelonRx Job Description: Revenue Cycle Management (RCM) Consultant - CarelonRx (Financial Consultant) Location: 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 if candidates reside within a commuting distance from an office. Please note that per our 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. CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member's health. The Revenue Cycle Consultant is a senior individual contributor responsible for establishing standard policies and procedures, advising on revenue cycle operating models, leading reengineering efforts, and identifying automation and transformation opportunities. This role brings broad and deep RCM expertise to help scale consistency, strengthen controls, and accelerate modernization across specialty and infusion pharmacy operations.

Your Match

How well this role fits your profile.

Company Intel

What employees say

Worked at Elevance Health (Anthem)? Share your experience