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Business Consultant (US)

Company: Elevance Health
Location: Sacramento
Posted on: January 28, 2023

Job Description:

**Business Consultant (US)**+ Job Family: Business Support+ Type: Full time+ Date Posted:Jan 03, 2023+ Req #: JR42059**Location:**+ National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint+ MO, Jefferson City+ CO, Denver+ IN, Indianapolis+ NV, Las Vegas**Description****Business Consultant****Location** : Remote opportunity-all locations to be considered.This is an opportunity to join a growing team of associates within DBG. Our team is responsible for identifying claims processing issues on WGS through data mining and then creating business requirements documents (BRD) to create data mining queries that will contribute to cost of care savings and total program savings. This position will primarily perform WGS tasks in conjunction with the pre-pay initiative project for Datamining and Overpayments (DMO).**How you will make an Impact;**+ Takes initiative to discover new prevention opportunities for CoC & TPS savings.+ Evaluates overpayment opportunities by identifying and reviewing WGS claim samples.+ Researches leads to identify additional prevention savings opportunities.+ Researches all business documentation to develop accurate and robust queries.+ Analyzes provider contracts, company claims policies and coding guidelines to identify and support prevention opportunities.+ Writes Business Requirement Documents (BRD) and demonstrated experience and ability to perform UAT for low to high complexity projects.+ Partners closely with Query Developers to ensure business requirements will be incorporated into recovery query design and testing.+ Determines specific business application software requirements to address complex and varied business needs.+ Manages projects with clear documentation and follow up.+ Facilitates meetings, including meeting preparation and documentation.+ Manages and prioritizes work assignments based on business goals.+ Coordinates concept expansions, enhancements and UATs as the POC, for concepts.+ Identifies process improvement opportunities that result in increased savings.+ Consults with business partners concerning processes, procedures, contracts, processing rules and other system rules to identify overpayments.+ Provides direction and guidance to analysts and serves as an expert for the team.**Minimum Requirements** :Requires a BA/BS and minimum of 8 years business analysis experience, which should include analysis and project management; or any combination of education and experience which would provide an equivalent background.**Preferred Skills, Capabilities and Experiences:**+ Commercial claims experience+ Experience with WGS+ Advanced skill level with MS Excel, pivot tables, formulas, V-lookup, etc.+ Must possess strong analytical and problem-solving skills with research-oriented approach; strong written, verbal and interpersonal communication skills are required+ Ability to manage multiple projects in various stages to completion+ Demonstrated meeting facilitation skills .+ For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skillsFor candidates working in person or remotely in the below locations, the salary* range for this specific position is $82,400 to $142.140Locations:?Colorado; Nevada, Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NYIn 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 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 for assistance.EEO is the LawEqual Opportunity Employer / Disability / VeteranPlease use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.+ EEO Policy Statement+ EEO is the Law Poster+ EEO Poster Supplement-English Version+ Pay Transparency+ Privacy Notice for California ResidentsElevance Health, Inc. is an E-verify EmployerNeed Assistance?Email us ( or call 1-877-204-7664

Keywords: Elevance Health, Sacramento , Business Consultant (US), Other , Sacramento, California

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