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  • Rating/Claims System Advisor

    Elevance Health (St. Louis, MO)



    Apply Now

    Rating/Claims System Advisor

    **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 remote work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.

     

    The **Rating/Claims System Advisor** will be responsible for providing support, configuration, design, testing and implementation for ratings or claims systems.

    How you will make an impact:

    + Translates the most highly complex and varied business needs into application software functionality.

    + These needs typically involve a significant expenditure or cost savings and impact a wide range of functions.

    + Works with business owners to identify and analyze requirements and processes with Information Technology and the vendor to ensure quality and timeliness of systems/project deliverables.

    + Configures new designs/updates in the system.

    + Monitors system and business functionality and performance

    + Documents and tracks product defects.

    + Coordinates problem resolution with development and/or product vendors

    + May implement rates, rating formulas, product and benefit configuration/information and as directed by the appropriate business unit.

    + Analyzes, develops and validates data.

    + Researches, documents and completes very diverse and complex projects and work processes to ensure business continuity and consistency.

    + Formulates and defines system scope and objectives based on user-defined requirements.

    + Supports and maintains the systems post-implementation.

    + Provides end user support, consultation, liaison communications, helpdesk triage, training, reporting, auditing, application security, and ad hoc inquiries and requests.

    + Provides expertise to lower-level analysts.

    Minimum Requirements:

    Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and experience, which would provide an equivalent background.

    Preferred Skills, Capabilities, and Experiences:

    + Experience with Excel strongly preferred.

    + Experience with claims testing strongly preferred.

    + Experience with claims systems and processes strongly preferred (i.e. WGS, Facets, etc.).

    + Data analysis experience preferred.

    + SQL experience preferred.

    + Familiarity with CPT codes preferred.

    + Experience with Jira and/or Confluence preferred.

    + Agile experience strongly preferred.

    + Familiarity with BRD (business requirements document) preferred.

    + Prior experience mentoring, training, and/or coaching preferred.

     

    For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $93,404 to $154,854.

     

    Locations: Maryland, Minnesota

     

    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 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 [email protected] 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.

     


    Apply Now



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