Location: Louisville KY, Overland Park KS, Grand Prairie TX, Tampa FL, Atlanta GA, Mason OH, Indianapolis IN

Hours: Standard Working hours  

Travel: 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. 

 
Position Overview:  

Responsible for leading the process of preparation and interpretation of complex risk adjustment, revenue or financial analysis for the Medicaid line of business. Has end to end ownership/management of Medicaid Risk Adjustment business processes and works across multiple Medicaid markets to drive holistic and consistent solutions. 

How You Will Make an Impact: 

• Leads risk adjustment and revenue initiatives aimed at improving business processes and, in some areas, developing innovative financial system solutions to reduce manual and repetitive work. 

• Manages enterprise or Medicaid business unit activities related to business case development, ROI analysis, cost-benefit realization, and other support for company investments. 

• Advises management by presenting solutions and recommended actions. 

• Mentors and trains team members. 

• Performs and documents complex risk adjustment, financial, and business analyses, including evaluations of financial and risk score performance, market nuances, and other revenue-related initiatives. 

• Prepares detailed analyses and reports for leadership and collaborates closely with internal and external auditors. 

• Partners with business teams to identify and implement strategic projects and risk adjustment programs that support company objectives. 

• Ensures compliance with state and federal regulatory requirements for risk adjustment functions across the enterprise. 

Required Qualifications:  

• Requires a BA/BS in Accounting or Finance and a minimum of 6 years budgeting, forecasting, and accounting financial reporting experience; or any combination of education and experience, which would provide an equivalent background. 

Preferred Qualifications:  

• MBA, MPH, MHA, CPA, CMA, FSA and/or CFA preferred.  

• Strong knowledge of internal business processes, data flow, controls and our financial systems preferred. 

• Strong knowledge of risk adjustment practices, Medicaid risk adjustment models, and Medicaid categories of aid (acute R.A. vs. MLTSS R.A.)  

• Experience with Snowflake, SQL, SQL Server, or equivalent strongly preferred.   

• Ability to present meaningful results to a business audience, to participate collaboratively in a team tasked to produce complex analyses on a rigorous schedule. 

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 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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.