Job Description

Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

Hours: Monday - Friday

Travel: Hybrid (1-2 days onsite)

Position Overview:

Responsible for coordinating and consolidating various impact analyses for management reporting.

How You Will Make an Impact:

• Conduct comprehensive research and analysis to identify trends, areas for improvement, and opportunities within Medicare markets ad provider networks.

• Gather and analyze data to develop insights aimed at optimizing provider performance.

• Identify innovative solutions tailored to address specific provider needs and challenges.

• Collaborate with cross-functional teams to develop strategies and action plans for implementing solutions.

• Present research findings and proposed solutions to providers clearly and persuasively.

• Build and maintain strong relationships with providers to facilitate collaboration and acceptance of solutions.

• Contribute to the development and implementation of strategic initiatives aimed at improving risk adjustment outcomes.

• Monitor the effectiveness of implemented solutions and make necessary adjustments to ensure optimal outcomes.

• Develop metrics and KPIs to track the success of solutions and improvements.

• Prepare comprehensive reports and dashboards to communicate performance improvements to stakeholders.

• Serves as a strategic partner to the business and contributes to ideas and solutions

• Influences others and works effectively to establish and develop working relationships both internally and externally with business stakeholders

• Serves as a subject matter expert on Risk Adjustment programs and risk adjustment payment methodology

• Leads and consults with operations on ad hoc requests/special projects

Required Qualifications:

• Requires a BA/BS degree in Statistics, Economics, or Business Administration and minimum of 8 years of relevant experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• Strong analytical, organizational, presentation, and problem-solving, critical thinking skills strongly preferred.

• Healthcare business knowledge related to Risk Adjustment Payment Methodology

• Proven track record of successfully implementing provider solutions that led to measurable improvements.

• Ability to interpret and analyze complex data and translate this into meaningful, actionable information for provider groups and/or market leads

• Skilled at managing multiple projects involving cross-functional teams and maintaining high standards of quality and accuracy

• This role requires a professional with a blend of technical expertise and strong interpersonal skills to effectively consult and guide provider groups on effective use and interpretation of risk adjustment data and KPIs

• Advanced skills in Microsoft Office Suite, especially Excel for data handling and analysis, and PowerPoint for presentations

• Proficiency with Business Intelligence software like Tableau, Power BI to create reports and visualizations

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 and Influenza. 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 [email protected] for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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