at Elevance Health in Chicago, Illinois, United States
Job Description
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.
Ideation Consultant Senior – Payment Integrity
+ Job Family: RDA > Business/Health Info
+ Type: Full time
+ Date Posted:Apr 01, 2024
+ Anticipated End Date:Apr 29, 2024
+ Reference: JR111197
Location:
+ GA, ATLANTA
+ Colorado, Denver
+ Washington, Seattle
+ Minnesota, Mendota Heights
+ Louisiana, Metairie
+ New York, New York City
+ New Jersey, Iselin
+ California, Woodland Hills
+ Ohio, Mason
+ Georgia, Atlanta
+ Kentucky, Louisville
+ Tennessee, Nashville
+ Rhode Island, Smithfield
+ Massachusetts, Woburn
+ New Hampshire, Manchester
+ District of Columbia, Washington
+ Delaware, Wilmington
+ Iowa, West Des Moines
+ Nevada, Las Vegas
+ Connecticut, Wallingford
+ Virginia, Richmond
+ Illinois, Deerfield
+ Texas, Grand Prairie
+ Illinois, Chicago
+ Wisconsin, Waukesha
+ North Carolina, Cary
+ Maryland, Hanover
+ Florida, Miami
+ West Virginia, Charleston
+ Maine, South Portland
Description
Ideation Consultant Senior (Business Information Developer Consultant Senior)
Location: This position will work on a hybrid model (1-2 times per week in the office). The ideal candidate will live within 50 miles of one of our office locations. With some travel as needed.
Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical-expense spending.
Come join our Carelon Payment Integrity’s Claims Anomaly Detection Team. Our team does data mining, finds anomalies, and validates our findings for external clients. The Ideation Consultant Senior (Business Information Developer Consultant Senior) is viewed as an expert in the development and execution of data mining analyses. We’re looking for candidates with claims and coding backgrounds, (claims coding and processing/adjusting, query coding, any combo of experience) who can research and data mine, detecting claims issues tied to coding inconsistencies, provider contracting, pricing, and reimbursement policies. Good communication, both written and verbal is important.
How you will make an impact:
+ Interact with query analysts and project teams.
+ Utilize relationship-building skills to build a network and trust with clients and business partners.
+ Manage and prioritize work assignments based on business needs.
+ Effectively research leads to identifying additional savings opportunities.
+ Determine specific business requirements to address complex client needs.
+ Serve as a liaison between the client, data technology, query analysts, and other business partners.
+ Analyze and design solutions to address complex and varied business needs.
+ Consult with business partners concerning the application and implementation of technology.
+ Provide direction and guidance to a variety of resources and serve as an expert for the team.
+ Ability to manage projects with clear documentation and follow-up.
+ Facilitate meetings to include meeting preparation and documentation.
+ Undertakes complex assignments requiring additional specialized technical knowledge.
+ Develops very complex and varied strategic report applications from a Data Warehouse.
+ Establishes and communicates common goals and direction for the team.
+ Establishes and maintains advanced knowledge of data warehouse database design, data definitions, system capabilities, and data integrity issues.
+ Acts as a source of direction, training, and guidance for less experienced staff.
+ Monitors project schedules and costs for own and other projects.
+ Develops and supports very complex Data Warehouse-related applications for business areas requiring design and implementation of database tables.
+ Conducts training on the use of applications developed.
+ This job is focused on spending time thinking about programming and how it would be used to design solutions.
Minimum Requirements:
+ Requires a BS/BA degree; minimum of 6 years experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Qualifications, and Experiences:
+ Certifications preferred (CPC, SAS or R, Python, Snowflake SQL) highly preferred.
+ Advanced skill level with MS Excel, pivot tables, formulas, V-lookup, and SQL coding experience desired.
+ Must possess strong analytical and problem-solving skills with a research-oriented approach; strong written, verbal, and interpersonal communication skills are desired.
+ Ability to manage multiple projects in various stages to completion desired.
+ Demonstrated business partner meeting facilitation skills preferred.
+ Expert-level PC, spreadsheet, and database skills, as well as experience in standard Business Information tools and programming/query languages, strongly preferred.
+ The ability to communicate effectively with multiple levels within the organization is strongly preferred.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $114,080 to $205,344
Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ
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 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 profession
