Anticipated End Date:

2025-12-30

Position Title:

Business Analyst III - Payment Integrity Datamining

Job Description:

Business Analyst III – Payment Intergrity Datamining

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.

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 will be responsible for serving as the liaison between the business and IT in translating complex business needs into application software.

How you will make an impact:

• Analyzes complex end user needs to determine optimal means of meeting those needs Determines specific business application software requirements to address complex business needs
• Develops project plans and identifies and coordinates resources, involving those outside the unit
• Works with programming staff to ensure requirements will be incorporated into system design and testing
• Acts as a resource to users of the software to address questions/issues
• May provide direction and guidance to team members and serves as an expert for the team
• Generate and refine creative recovery strategies that enhance our organization’s resilience through ideation of concepts, ensuring we are prepared and adaptable in the face of challenges.
• Work closely with subject matter experts to develop and prioritize business requirements, driving initiatives that align with our strategic goals and meet the needs of our stakeholders.
• Conduct thorough testing of processes and tools to ensure they meet high-quality standards and effectively support our business operations, contributing to overall efficiency and success.

Minimum Requirements:

• 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.

Preferred Skills, Capabilities, and Experiences:

• Comprehensive understanding of healthcare payer systems, claims processes, and coding practices preferred.
• Demonstrated proficiency in analyzing complex data and creating clear, detailed documentation strongly preferred.
• Exceptional ability to communicate effectively with a variety of stakeholders, ensuring alignment and collaboration preferred.
• Proven track record of adapting to changing environments, effectively managing multiple tasks, and taking initiative preferred.
• Commitment to fostering a team environment characterized by transparency, adaptability, and a willingness to give and receive feedback desired.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions.

Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions
Associates in these jobs must follow the specific policies, procedures, guidelines, etc
as stated by the Government Business Division in which they are employed.

Job Level:

Non-Management Exempt

Workshift:

1st Shift (United States of America)

Job Family:

BSP > Business Support

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.

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.