Business Information Analyst Senior – Medicaid Encounters Data

Anticipated End Date:

2025-09-26

Position Title:

Business Information Analyst Senior – Medicaid Encounters Data

Job Description:

Business Information Analyst Senior – Medicaid Encounters Data

The Business Information Analyst Senior is responsible for analyzing and validating healthcare encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role involves ensuring the accuracy and completeness of data, identifying trends, and providing insights to support decision-making and regulatory compliance.

Location: Norfolk, VA; Grand Prairie, TX; Tampa, FL; Mason, OH; Durham, NC (preferred). 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.

PLEASE NOTE: This position is not eligible for current or future visa sponsorship.

How you will make an impact:

• Analyze and validate Medicaid encounter data submissions for accuracy, completeness, and compliance with CMS requirements.
• Collaborate with internal teams to gather requirements and determine data reporting needs.
• Identify trends, anomalies, and issues in encounter data and provide actionable insights.
• Assist in developing data quality management processes and procedures.
• Provide support for CMS audits and other regulatory reporting requirements.
• Develop and analyze business performance reports (e.g., for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.
• Create and publish periodic reports, as well as any necessary ad hoc reports.
• Collaborate with IT and other departments to streamline data collection and reporting processes.

Minimum Requirements:

• Requires a BS/BA degree in a related field and a minimum of 3 years data analysis or related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Strong SQL skills are highly preferred.
• Ability to manipulate large sets of data is strongly preferred.
• Strong analytical, organizational, and problem-solving skills are strongly preferred.
• Knowledge of SAS.
• Knowledge of systems capabilities and Healthcare business operations. 
• ASC X12 837 EDI experience.
• Intermediate Microsoft Excel experience.
• Facets systems knowledge considered a plus.
• Claims and/or Encounters experience preferred.
• Experience with Medicaid data preferred.

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