Job Description
Anticipated End Date: 2026-02-28
Position Title: Business Information -Consultant - Provider Economics
Job Description: Business Information -Consultant - Provider Economics 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.
The Business
Information Consultant - Provider Economics is responsible for generating and validating affinity, attribution, and membership and population segmentation. Identify and stratify members into Affinity, Attribution, Care Management, VBC Program membership and Market benchmark populations based on member preference, visit patterns, clinical criteria, geography, product, LOB and other member segmentation levers.
Assigns members to primary and/or specialty providers based on observed care patterns or declared relationships (provider affinity), and simultaneously evaluates whether those members meet clinical, demographic, and product-based criteria to be considered for participation in Carelon-led clinical interventions and/or risk-bearing programs. From the qualified target population, assigns members to specific risk arrangements and defines both target and performance benchmarks to determine their eligibility for care management, shared savings and other incentives. Serve as an expert in data analysis, reporting and formulating recommendations and providing guidance to other data analysts.
How you will make an impact: - Creates and maintains databases to track business performance.
- Analyzes data and summarizes performance using summary statistical procedures.
- Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.
- Creates and publishes periodic reports, as well as any necessary ad hoc reports.
- May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.
- May make recommendations based upon data analysis.
- Provides analytic consultation to other business areas, leadership or external customers. Data analysis and reporting encompasses a much higher level of complexity.
Minimum Requirements: Requires a BS/BA degree in related field and a minimum of 5 years experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, & Experiences: - Experience with relational databases and knowledge of query tools and statistical software preferred.
- Ability to manipulate large sets of data strongly preferred.
- Strong analytical, organizational, presentation, and problem solving skills strongly preferred.
- Strong analytical and technical skills, including proficiency in SAS, SQL, Snowflake, or similar data manipulation tools preferred.
- Strong communication skills to present clear, concise presentations of the detailed analytics preferred.
- Documentation of assumptions and technical requirements, and developing clear, concise presentations for both technical and non-technical audiences preferred.
- Experience providing leadership in evaluating financial performance of complex organizations preferred.
- BA/BS degree in Actuarial Sciences or Health Economics preferred.
- Minimum of 5 years in healthcare industry in medical economics, provider finance, healthcare analytics, or actuarial services preferred.
Job Level: Non-Management Exempt
Workshift: 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 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.
Job Tags
Temporary work, Work at office, Local area, 2 days per week, 1 day per week,