The Sr. Business Consultant will support the Advanced Primary Care risk adjustment team through vendor engagement, reporting and identifying areas for process improvement. The ideal candidate will have a healthcare background with a strong understanding of Risk Adjustment. You should have experience in data analysis and be comfortable working with large data sets and complex systems.
Location: This position will work a hybrid model (remote and office) and must live within 50 miles of one of our Pulse Point office locations.
How will you make an impact:
Partner with Program Director on end-to-end management of retrospective coding program
Collaborate with external vendors on contracting, performance, and program requirements
Responsible for vendor oversight and business support to cross functional teams.
Create monthly KPI reports for management review.
Build new reports or modify existing reports to identify risks/opportunities.
Collaborate within the risk adjustment team, as well as cross-functionally to create strategies for process improvement.
Develop standard and ad-hoc reporting based on business needs.
Identify opportunities within Prospective, Concurrent and/or Retrospective Coding Programs
Minimum requirements:
Requires a BA/BS and minimum of 10 years business analysis experience, which should include analysis, project management, working knowledge of mainframe computer, hardware and operating systems; minimum of 3 years experience as a Business Consultant with project management skills; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
Experience in risk adjustment and/or health insurance industry.
Experience in Medicare Advantage and Medicaid in a provider based or health plan setting.
Experience with external vendors, specifically those specializing in Risk Adjustment.
Strong verbal/written communication skills to work cross-functionally and externally.
Strong analytical, organizational, and problem-solving skills.
Strong data analytical skills utilizing MS Excel and other relevant database programs.
Ability to analyze and manipulate large and complex datasets.
Background in Medicare operations and/or financial reporting.
Exposure to provider or health plan operations.
Able to collaborate cross functionally with other team members and implement new procedures as needed.
Experience in workflow redesign and process improvement.
Experience using SQL, Alteryx, or another advanced analytics tool.
Advanced SQL and/or Excel skills.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $ 133,745 to $ 160,494.
Locations: California
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
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.
Who We Are
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
