Location: Indianapolis, IN preferred. Will accept applications from: Tampa FL, Atlanta GA, Grand Prairie, TX and Richmond, VA

Hours: Monday - Friday

Travel: Hybrid (1-2 days onsite per week)

Position Overview:

We are seeking a dedicated and detail-oriented Risk Adjustment Reconciliation Analyst to join our team. The successful candidate will play a crucial role in supporting our risk adjustment processes through diligent encounters data reconciliation, claims data validation, data management, reporting and analysis. This position requires a strong analytical mindset, technical skills, and the ability to effectively manage large datasets.

How You Will Make an Impact:

• Support risk adjustment programs by conducting thorough claims validation processes, ensuring data accuracy and consistency

• Manage and reconcile provider data, focusing on claims and encounters to ensure comprehensive and accurate data submissions

• Perform valuation analysis on incoming data submissions to assess and enhance data quality and integrity.

• Utilize scripting tools such as SQL, SAS to manipulate and analyze large datasets, generating actionable insights for decision-making

• Collaborate with cross-functional teams to develop and refine data validation methodologies and reconciliation processes

• Maintain up-to-date documentation of processes, analyses, and results to support audit readiness and continuous improvement

• Communicate findings and trends to stakeholders, providing clear and concise reports that inform strategic planning

Required Qualifications:

• Requires a BS/BA degree in related field and a minimum of 3 years data analysis or related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• Experience working with relational databases and knowledge of query tools such as SQL, SAS is strongly preferred

• Proven ability to manipulate and reconcile large sets of data, with an emphasis on claims and encounter submissions.

• Strong analytical, problem-solving and detail-oriented skills, ensuring high accuracy and reliability in deliverables.

• Excellent communication skills, with the ability to translate complex data findings into understandable insights for various audiences.

• Experience working with Medicare Advantage and knowledge of Risk Adjustment payment methodology is preferred

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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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.