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Elevance Health · 9 hours ago

Business Information -Consultant - Provider Economics

IL-CHICAGO, 233 S WACKER DR, STE 3700

Full-time

Hybrid

Senior Level

5+ years exp

Elevance Health is a health company dedicated to improving lives and communities. The Business Information Consultant - Provider Economics is responsible for generating and validating member segmentation and assigning members to providers based on care patterns, while also serving as an expert in data analysis and reporting.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

Generates and validates affinity, attribution, and membership and population segmentation

Identifies and stratifies 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)

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

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

Qualification

Data analysisSASSQLRelational databasesHealthcare analyticsProblem solvingPresentation skillsCommunication skillsOrganizational skills

Required

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

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

Benefits

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical

Dental

Vision

Short and long term disability benefits

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Company

Elevance Health

Glassdoor3.6

Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.

Founded in 1944

Indianapolis, Indiana, USA

10001+ employees

https://www.elevancehealth.com

H1B Sponsorship

Elevance Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (488)

2024 (604)

2023 (660)

2022 (222)