Elevance Health

Business Analyst III - Provider Contract Analyst. Supports the Payment Integrity line of business. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.. Maintains data used by Data Mining Operations to ensure accurate claim disbursement.. Proficiency in Payment Integrity Data Mining Operations system functionalities and business processes is highly preferred.

business analyst iii

WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.
Business Analyst III - Provider Contract Analyst
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Job Family: Business Support
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Type: Full time
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Date Posted:Mar 20, 2024
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Anticipated End Date:Apr 20, 2024
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Reference: JR108333
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Location:
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IN, INDIANAPOLIS
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Georgia, Midland
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Colorado, Denver
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New York, New York City
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New Jersey, Iselin
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Ohio, Seven Hills
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Texas, Houston
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Virginia, Richmond
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California, Woodland Hills
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Texas, Grand Prairie
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New York, Latham
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Illinois, Chicago
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Wisconsin, Waukesha
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California, Walnut Creek
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Georgia, Atlanta
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Maryland, Hanover
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Kentucky, Louisville
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Ohio, Columbus
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Tennessee, Nashville
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Florida, Miami
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Florida, Tampa
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Massachusetts, Woburn
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Virginia, Norfolk
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North Carolina, Winston
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New Hampshire, Manchester
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New Jersey, Morristown
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California, Costa Mesa
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District of Columbia, Washington
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Description
Business Analyst III - Provider Contract Analyst
Supports the Payment Integrity line of business
Location: Must live within 50 miles of one of the posted Elevance Health offices.
Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.
The Business Analyst III is responsible for finding and analyzing provider contract documents, provider manuals, and reimbursement policy. This position will utilize these insights and other systems to verify software data and keep up-to-date information which will enable Data Mining Operations to identify claim disbursement inaccuracies.
How you will make an impact:
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Maintains data used by Data Mining Operations to ensure accurate claim disbursement.
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Determines specific business application software requirements to address complex business needs.
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Develops project plans and identifies and coordinates resources, involving those outside the unit.
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Works with programming staff to ensure requirements will be incorporated into system design and testing.
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Be a resource to software and data related to provider claim disbursement to address questions/issues.
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Provides guidance to team members.
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Minimum Requirements
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<li>Requires a BA/BS and minimum of 5 years business analysis experience; or any combination of education and experience which would provide an equivalent background.</li>
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Preferred Qualifications
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Proficiency in Payment Integrity Data Mining Operations system functionalities and business processes is highly preferred.
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Experience with Contraxx, claims coding, facility contract language, reimbursement policy, provider manuals, and WGS is highly preferred.
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Knowledge and hands-on experience with MS applications, namely Excel, Teams, OneNote, PowerPoint, and SharePoint.
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Experience in detecting and scrutinizing issues as well as ascertaining suitable solutions.
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Experience in assessing extensive data sets to discover patterns and potential issues.
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Excellent organizational skills and ability to function both independently and collaboratively.
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Robust communication and engagement abilities, comfortable interacting with and presenting to various levels in the organization.
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Strong problem-solving capabilities.
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For candidates working in person or remotely in the below locations, the salary* range for this specific position is $69,120 to $124,416.
Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ
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 .
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<li>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.</li>
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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.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.
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EEO Policy Statement
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Know Your Rights
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Pay Transparency
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Privacy Notice for California Residents
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Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)
Need Assistance?
Email us (elevancehealthjobssupport@elevancehealth.com) 
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