Responsible for serving as the liaison between the business and IT in translating complex business needs into application software. This position is key to driving and maintaining day to day operation data oversight and new product implementations. Plays a key role on all system modification testing oversight and production validation to avoid operation and compliance risk and increase member provider satisfaction. Responsible for serving as the liaison between the business and IT in translating complex business needs into application software. 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 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. Provides direction and guidance to team members and serves as an expert for the team. Maps the business processes, organization and technology to the new solutions. Identify gaps and implement solutions based on experience and best practices. Works with IT to develop Requirements and ensure requirements are incorporated into business and system designs and test plans. Acts as a resource to multiple functional users of the software to address questions/issues. Understands major Information Technology systems and the level of support provided for key business processes Assists project managers in crafting and delivering difficult messages regarding scope. Creates and executes test plans, test data and scripts and identify areas for correction. Develops programs from complex design specs, demonstrates understanding of transactions and major business process options in a complementary functional areas. Creates design for solution requirements (e.g., gap analysis, processes, interfaces, reports, enhancements, etc.). Implement system modification and updates pertaining to state mandated changes, internal new product implementation and system glitches modification.
Primary duties may include, but are not limited to:
- 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.
- Assist with pulling various reports and data points to support population health management workgroups
- Summarize data (including clinical data) and report findings to the team
- Assist with root cause analysis to identify opportunities for improvement
- Assist with the development of dashboards to track and trend KPIs
- Assistance with regulatory state reports
- Ad hoc analytics requests to support clinical programs
- Claim experience and knowledge expertise on claim Medicaid and Facets system
Minimum Requirements : 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, qualifications and experience . Knowledge of systems capabilities and business operations is strongly preferred.
For candidates working in person or remotely in the below locations, the salary range for this specific position is $80,064 to $120,096
Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY
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.
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
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.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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@example.com for assistance.