Business Consultant - Payment Integrity Datamining

Anticipated End Date:

2025-12-30

Position Title:

Business Consultant - Payment Integrity Datamining

Job Description:

Business Consultant – Payment Integrity Datamining

Location: 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.

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.

The Business Consultant will be responsible for translating moderately complex and varied business needs into application requirements. Possesses full technical knowledge of most phases of systems and business analysis and is able to consider the business implications of the application of technology to current and future business environments.

How you will make an impact:

• Will functions at a strategic level, supporting leadership as a chief-of-staff–style advisor
• Will ensure quality governance, evaluate high-complexity concepts, mentor, analyze and lead
• May lead teams of analysts assigned to complex projects
• Determines specific business application software requirements to address complex and varied business needs
• Analyzes and designs solutions to address complex and varied business needs
• Consults with business partners concerning application and implementation of technology
• Evaluate and translate business needs
• Design business/technology solutions
• Advise partners on system enhancements
• Validate complex concepts/work products

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:

• Demonstrates a strong ability to set a clear vision and strategy that effectively guides teams towards achieving organizational goals highly preferred.
• Extensive experience in quality assurance governance and data loss prevention, ensuring compliance with internal and external standards highly desired.
• Possesses exceptional analytical skills to solve complex problems, make data-driven decisions, and derive actionable insights desired.
• Excellent communication skills, capable of influencing and collaborating effectively with stakeholders at all levels to drive initiatives forward desired.
• Thrives in uncertain or evolving environments with the capability to navigate and manage projects where guidelines and outcomes are not clearly defined desired.
• Embodies team values of transparency, adaptability, and maintaining a feedback-positive mindset to contribute positively to team dynamics and growth desired.
  
  
  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
  Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions
  Associates in these jobs must follow the specific policies, procedures, guidelines, etc
  as stated by the Government Business Division in which they are employed

Job Level:

Non-Management Exempt

Workshift:

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 resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

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 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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 elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.