Payment Innovation Director

Elevance Health has announced several leadership appointments across its Health Benefits and Carelon organisations to strengthen execution and drive growth. Carelon, the company's services business, serves over 90 million consumers across healthcare, whilst Health Benefits serves over 45 million medical members. Key appointments include Aimée Dailey as President of Government Business, and Kristy Duffey joining as President of Carelon Health. Will Feest becomes President of Carelon Insights, William Fleming joins as Chief Growth and Strategy Officer for Carelon, Darrell Oliveira is named CFO for Carelon, and Jeff Plante becomes CFO for Health Benefits. The restructuring aims to better align capabilities, accelerate decision-making, and improve enterprise efficiency as Carelon continues to scale. Elevance Health serves approximately 104 million consumers across its diverse healthcare portfolio.

Elevance fills slew of mid-level leadership positions. The company has been overhauling its executive bench as it attempts to bolster flagging insurance profits and capitalize on growth in Carelon, including through six new appointments. Published March 31, 2026 Dive brief: * Elevance announced a slate of mid-level executive appointments on Tuesday as the company continues to shuffle its leadership roster to try to combat waning profits. * The insurer named two new executives to its health benefits division, including a new president of government business after the previous president was promoted to lead Elevance's broader insurance arm. Carelon, Elevance's health services division, added four new executives, including its first chief growth and strategy officer as the company seeks to accelerate Carelon's expansion. * The appointments are effective immediately. Dive insight: In a Tuesday release, Elevance said the appointments would improve the company's execution and support growth across its businesses - especially in Carelon, which has proved a reliable source of revenue and earnings even as Elevance's core health benefits division has struggled in recent years. Carelon, which Elevance officially formed in 2022, offers pharmacy benefits management, medication delivery, speciality pharmacy and infusion services through CarelonRx, along with care delivery and chronic care management through Carelon Services. The division has been a recent bright spot for Elevance in the company's otherwise dour financial results. Though Elevance expects revenue and profit to fall in 2026, the company maintains it should be able to grow earnings in 2027 in large part thanks to Carelon, which has continued to outperform expectations for growth. Seeking to capitalize on this momentum, Elevance has bolstered Carelon's advisors and executive suite, adding two veterans of the pharmaceutical industry to its board last year and naming Mark Kaye, Elevance's CFO, as the head of the division in February. Now, Carelon is rounding out its executive bench, naming William Fleming, a veteran healthcare executive who spent 30 years at Humana mostly in pharmacy and health services leadership roles, as its inaugural chief growth and strategy officer. Fleming will be responsible for Carelon's growth strategy, partnerships and portfolio expansion, Elevance said. Carelon also nabbed a new president, Kristy Duffey, to lead clinical strategy and operations across advanced primary care, behavioral health, specialty care and home care. Though most recently chief clinical officer at home and community care provider Cinqcare, Duffey also spent almost 15 years at Optum, UnitedHealth's massive health services division, in a variety of nursing and clinical operations roles, according to her LinkedIn. Will Feest, currently Carelon's chief operating officer, will become president of Carelon Insights in addition to his current role. Feest was also Carelon's chief financial officer, but is handing that position over to newcomer Darrell Oliveira, who is joining Carelon from reinsurance provider North American Life and Health. The company said its new leadership appointments will also improve coordination in Elevance's health benefits division, which covers more than 45 million members. Like its peers, Elevance has struggled with flagging margins in government programs as higher medical utilization is met with what payers argue is inadequate reimbursement in Medicare and Medicaid. Spending is also rising in Affordable Care Act plans, too - a stressor insurers expect to be exacerbated this year after Congress allowed more generous subsidies for Affordable Care Act coverage to expire. In February, Elevance consolidated control of its various health insurance businesses under Felicia Norwood, the company's former head of government benefits. And now, Elevance has named Aimée Dailey to fill Norwood's old role. Dailey, who most recently led Elevance's Medicare business, has been with the insurer for more than a decade. Jeff Plante, the former president of Carelon's analytics arm, was also named health benefits' chief financial officer. It's the first time that Elevance's health benefits segment has had a designated CFO, according to a spokesperson. Still, Elevance's insurance division is also losing personnel. Kurt Small, Elevance's Medicaid president, is leaving the company to become CEO of CareFirst, a large nonprofit insurance provider. CareFirst announced the news on Tuesday. Recommended reading. Filed Under: Payer

Regulatory pressure is real: compliance is no longer optional. The regulatory tone across Centers for Medicare & Medicaid Services (CMS), Office of Inspector General (OIG), and the U.S. Department of Justice (DOJ) has materially shifted - and the data proves it. In fiscal year 2025 alone, False Claims Act settlements and judgments reached $6.8 billion - the highest in history, with over $5.7 billion tied directly to healthcare. This is not just enforcement - it is a clear signal that healthcare organizations are under intensified scrutiny, particularly across Medicare Advantage, risk adjustment, and clinical documentation practices. Recent high-profile cases illustrate the focus: * Aetna ($117.7M) - Allegations centered on submitting unsupported diagnosis codes (e.g., morbid obesity) and failing to delete inaccurate codes, inflating Medicare Advantage payments. * Kaiser Permanente ($556M) - Accused of using chart reviews and addenda programs to add diagnoses not supported by clinical documentation, with internal incentives tied to risk score increases. * Elevance Health - Facing ongoing litigation tied to alleged kickbacks and Medicare Advantage practices, signaling continued DOJ expansion into payer relationships and distribution models. * Providers in New York and beyond - Increasing enforcement tied to medically unnecessary services, kickbacks, and improper billing practices - reinforcing that providers are equally exposed. What's different now? These are not isolated errors - they are systemic, program-level allegations tied to workflows, incentives, and operational design. What this means for Health plans & medical groups. This environment demands immediate action. Organizations should proactively review: * Clinical coding accuracy and validation processes * Virtual scribe and documentation workflows * Data mapping and interoperability logic (FHIR/HL7/API pipelines) * AI-driven alerting and diagnosis suggestion practices * Retrospective review and addenda protocols * Billing integrity and overpayment return processes Margins in healthcare are thinner than ever. The cost of non-compliance is no longer just financial - it is reputational, operational, and strategic. The bottom line. These are serious times. Compliance must be embedded - not audited after the fact. Teams must be educated, governance must be real, and leadership must demand transparency across clinical and operational workflows. Now is the time for a fresh, independent lens on oversight, coding, value based contracting, and clinical practices. Because in today's environment - what you don't see is exactly what regulators will.