Business Information Analyst Sr. - Cost of Care

Anticipated End Date: 2025-02-12 Position Title: Business Information Analyst Sr. - Cost of Care Job Description: Business Information Analyst Sr. - Cost of Care Location: This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live within 50 miles of one of Elevance’s Pulse Point locations. The Business Information Analyst Sr. - Cost of Care is responsible for providing utilization management services, and we’re seeking a self-starting individual who can effectively utilize a combination of critical thinking and analytics skills to demonstrate the financial value of new services and capabilities. How you will make an impact: • Establish actuarially-sound cost modeling and forecasting methodologies that accurately assess future business performance across new go-to-market solutions and capabilities. • Obtain, verify, analyze, and model financial target outcomes such as return-on-investment (ROI) and payback periods using claims and authorization data. • Lead and/or actively participate in new solution strategy sessions with Carelon MBM/PAS medical directors and Solution Design consultants. • Partner with Actuarial team members to validate cost model outcomes, savings modeling assumptions, and ROI recommendations. • Identify medical cost, service utilization, service intensity, unit cost, and membership trends to identify new opportunities for product expansion. • Understand cost levers of Carelon MBM/PAS services and make recommendations on program design. • Accountable for developing a measurement system to assess financial performance of new solutions following implementation. • Ensure that cost and saving model assumptions are tracking with actual solution performance. • Structure and perform independent analyses and package findings for executive level stakeholders. • Conduct exploratory research on medical finance and cost-of-care outcomes by publishing key cost trends and benchmarks. • Serve as a subject matter expert in trend decomposition to inform the business of key financial risks that require more proactive surveillance. • Use R, SQL, Excel, PowerPoint, and other tools to transform data into insights and report findings to internal and external business partners. Minimum Requirements: Requires a bachelor’s degree; minimum of 3 years of customer service experience including 2 years of experience in a healthcare or provider environment; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences: • BS/BA degree in Mathematics, Statistics, Finance, Computer Science or a quantitative-related field; minimum of 3-5 years related experience in an analytics environment performing medical economics reporting, price setting, evaluation of financial risks and trend projections; or any combination of education and experience preferred. • Experience specific to health insurance or health insurance claims data or graduate level related education may also be used to offset years of experience. • Familiarity with medical management or population health programs is preferred. • Possession of working knowledge of healthcare data and measurement standards such as ICD10, CPT/HCPCS, MS-DRG, DxCG, PMPM, and utilization per 1,000 preferred. • Advanced SQL and Excel skills strongly preferred. • Base statistical skills to analyze, display, describe and summarize data into actionable insights preferred. • Data visualization experience in QlikSense, Business Objects, Tableau, or other BI tools is preferred. • Excellent organizational, analysis planning, and communication skills is strongly preferred. • Ability to participate collaboratively on teams producing complex analyses strongly preferred. • Healthcare Analytics consulting experience strongly preferred. • Excellent analytical and critical thinking skills preferred. For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $82,016 to $123,024. Locations: Chicago, Illinois 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. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: RDA > Business/Health Info 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 elevancehealthjobssupport@elevancehealth.com 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. Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading. Join our Talent Community and stay connected with company news, information, and future job opportunities. Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner.  Our nearly 100,000 associates serve approximately 100M people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health.  Please visit the Contract Worker Community Page. Elevance Health is an Equal Opportunity Employer/Disability/Veterans.

Salary : $82,016 - $123,024