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Elevance Health Business Consultant - Commercial Claims Anomaly Detection (Documentation & Training) in Des Moines, Iowa

Business Consultant - Commercial Claims Anomaly Detection (Documentation & Training)

  • Job Family: Business Support

  • Type: Full time

  • Date Posted:Jan 20, 2023

  • Req #: JR40272


  • OH, Mason

  • PA, Seven Fields

  • FL, Jacksonville

  • VA, Richmond

  • WI, Madison

  • NJ, Iselin

  • National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint

  • KY, Louisville

  • CA, Los Angeles


The Commercial Claims Anomaly Detection (CAD) team within Payment Integrity is filling a Business Consultant position. The role will serve as a subject matter expert for the department and must have documentation and training focus. . Consults with management on solutions to global business issues and organization improvements. Analyzes, develops and trains existing and potential workflows, processes, supporting systems and procedures. Identifies improvements and opportunities for standardization. This position has a strong understanding of systems and enterprise-wide strategic focus. Provide requested direction and guidance to team members and serve as an expert for the team.

Primary duties may include, but are not limited to:

  • Develop training curriculum for virtual and flipped classroom training.

  • Lead various projects, committees, or work groups to develop, implement, modify and document new or revised processes, procedures, systems and tracking mechanisms.

  • Coordinate and facilitate training.

  • Support associates post-training.

  • Represent the department on strategic projects and initiatives. Represent the department in meetings and relays information to production teams.

  • Work with management in developing regional and corporate strategy.

  • Ensure new processes are aligned to organizational standardization.

  • Perform complex data analysis and makes recommendations based on the results.

  • Create, develop, and implement process improvements with an enterprise-wide focus.

  • Counsel and influence other departments to ensure positive outcomes for the department.

  • Counsel and influence commercialization management team and helps shape positive outcomes within the department.

  • Use discretion in making independent decisions.

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 Experiences:

  • 8+ years’ experience in developing training documentation, training facilitation, project management

  • CEP instructional design (or other) methodology, PMP, auditing, claims/systems training, professional and facility claim adjustments, content development, performance support tools, and provider reimbursement methodologies

  • Proficiency in MS Excel, intermediate to advanced proficiency with MS Power Point

  • Detailed job/task analysis documentation, mastery of developing training curricula and documentation, training experience, excellent verbal and written communication skills, effective virtual presentation and facilitation, research and data analysis experience, critical thinking, strong decision-making, strong technical aptitude, collaboration, and ability to prioritize work.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $82,400 to $142,140.

Locations: Colorado; Nevada, 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. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

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 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 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at 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 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

  • Pay Transparency

  • Privacy Notice for California Residents

Elevance Health, Inc. is an E-verify Employer

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