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Medicare Risk Adjustment Advanced Analytics Consultant

**On-Site Requirement: Hybrid 1;** **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 **Medicare Risk Adjustment Advanced Analytics Consultant** is responsible for employing advanced analytics to gain critical insights into Medicare and ACA risk adjustment performance, retrospective and prospective risk adjustment initiatives, operational effectiveness and efficiencies, provider performance, and population health. This role will consult with business leaders and internal partners to apply the insights to drive risk adjustment program innovation and enhancement, to target the right members for the right service, to measure program outcomes, and to support information-based strategic decision making.

How You Will Make an Impact

Primary duties may include, but are not limited to:

+ Provides analytical insights to support business solution development for Medicare and ACA risk adjustment initiatives.

+ Analyzes and develops SAS and SQL programming to support Medicare and ACA risk adjustment programs

+ Performs data mining and data-driven analyses to evaluate historical program performance and to inform current operating decisions.

+ Participates in peer-to-peer review process to reduce report writing errors and rework.

+ Assists in training of actuarial trainees, analysts, and specialists.

+ Consults on all considerations related to designing and executing tests or pilot programs.

+ Contributes to the design of new program/initiative based on test/pilot outcomes.

+ Develops targeting criteria or customer segmentation based on analytical insights, clinical inputs, product design and operations considerations.

+ Develops predictive models and other tools that help target the right members.

+ Develops methodology to measure clinical, utilization and financial outcomes of a program/initiative.

+ Conducts in-depth research to address challenging issues in measuring outcomes.

Minimum Requirements:

+ Requires MS, MA, or PhD with concentration in a quantitative discipline such as Mathematics, Statistics, Economics, Epidemiology, Engineering, Computer Science or Operations Research and a minimum of 5 years’ experience in related health care analytics; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, & Experiences:

+ Advanced expertise with SAS or equivalent analytical tools and comprehensive experience with Teradata, SQL, or equivalent database tools strongly preferred.

+ 5+ years of risk adjustment analytics experience for government programs.

+ Proven written and verbal communication skills in a collaborative environment.

+ Comfortable with sharing complex ideas or findings with senior leaders.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $103,664 to $196,416 annually.

Locations: Colorado, Illinois, New Jersey, Maryland, Minnesota, and New York

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.

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.