Elevance Health Business Analyst II - Cost Containment in Bismarck, North Dakota
Business Analyst II - Cost Containment
Job Family: Business Support
Type: Full time
Date Posted:May 25, 2023
Req #: JR71345
National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
Business Analyst II - Cost Containment
Location: Aligned to an Elevance Health office but will the ability to work remotely.
The Cost Containment Unit (CCU) is an operational unit that leads the effort to identify, analyze, validate and avoid medical overpayments. Cost Containment’s goal is to deliver measurable cost savings through expense recovery and cost avoidance. This will include translating basic business needs into application software requirements.
How you will make an impact:
Analyzes business needs to determine optimal means of meeting those needs.
Determines specific business application software requirements to address specific business needs.
Works with programming staff to ensure requirements will be incorporated into system design and testing.
Acts as liaison with users of the software to address questions/issues.
Perform data mining utilizing CPT, HCPCS, DRG, ICD-9, ICD-10, etc., to identify recovery opportunities.
Research all resource documents and web-sites.
Document findings that support the concept.
Request and/or run queries as needed to retrieve data.
Meet with various business partners as needed.
Validate overpayments, complete Approach document and forward necessary files and documents for CCU Load.
Submit enhancement request for database updates.
Ensures proper review of the Forager Pipeline and Analyst reports.
Commit to deliverables and maintain timely turnaround times.
Requires a BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
Healthcare business analysis experience preferred.
Experience in using Facets, SQL and MACESS highly preferred.
Medical billing and/or claims processing experience is preferred.
2+ years of experience with data analysis, claims processing, provider billing, FWA investigations, cost containment, Medicare, Medicaid, MMP and/or MedSupp plans strongly preferred.
Medical coding experience - CPT, HCPCS, ICD-9/10 coding preferred.
CPC or applicable professional designation preferred.
Proficient of Microsoft Office products, most notably expertise in Excel for reporting, Word, PowerPoint, Teams, and Outlook strongly preferred.
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 skills.
If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position¿ work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $57,200 to $102,960
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. A Fortune 20 company with a longstanding history in the healthcare industry, 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 in certain patient/member-facing roles 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. 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 firstname.lastname@example.org for assistance.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.
EEO Policy Statement
Know Your Rights
Privacy Notice for California Residents
Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)
Email us (email@example.com) or call 1-877-204-7664