Business Consultant Sr (Medicare Risk Adjustment)

Anticipated End Date:

2025-06-06

Position Title:

Business Consultant Sr (Medicare Risk Adjustment)

Job Description:

Location:  Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

Hours: Monday - Friday

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 remote work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.

Position Overview:

Responsible for translating most highly complex and varied business needs into application software requirements. These needs typically involve a significant expenditure or cost savings and impact a wide range of functions. Also, provides expertise to lower leveled consultants

How You Will Make an Impact:

• This role requires a professional with a blend of technical expertise and strong interpersonal skills to effectively consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs

• Provides expertise to lower-level consultants on the analysis of business needs to determine optimal means of meeting those needs

• Determines specific business application software requirements to address the most highly complex and varied business needs

• May lead teams of analysts assigned to the most complex projects, typically those of highest importance and impact to the way in which we do business

• Analyzes and designs solutions to address varied and highly complex business needs

Required Qualifications:

• Requires a BA/BS and minimum of 10 years business analysis experience, which should include analysis, project management, working knowledge of mainframe computer, hardware and operating systems; minimum of 3 years’ experience as a Business Consultant with project management skills; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

• Working knowledge of Medicare is strongly preferred 

• Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly preferred

• Advanced skills in Microsoft Office Suite, especially Excel for data handling and analysis, and PowerPoint for presentations

• Proficiency with Business Intelligence software like Tableau, Power BI to create reports and visualizations

• Experience working with relational databases and knowledge of query tools such as SQL, SAS, Teradata is strongly preferred

• Strong analytical, organizational, presentation, communication, and problem-solving, critical thinking skills strongly preferred.

• Proven track record of successfully implementing solutions that led to measurable improvements.

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 resour