Elevance Health

Business Intelligence Developer

• Analyzing, reporting and developing recommendations on data related to multiple, varied business metrics
• Creating and maintaining databases to track business performance
• Analyzing data and summarizing performance using summary statistical procedures
• Developing and analyzing business performance reports for claims data, provider data, and utilization data
• Providing notations of performance deviations and anomalies
• Creating and publishing periodic reports, making recommendations, and developing ad hoc reports as needed
• Monthly reporting for CMS
• Partnering with business, operations, and clinical stakeholders

Healthcare Business Intelligence Analyst II

Call Center Representative

• Identify, track, and reconcile overpayments made to providers
• Ensure that recovery is made and reported under general supervision
• Perform all authorized duties in the processing of overpayments allocated to the assigned market
• Provide exceptional service to member, providers, group administrators and attorneys
• Identify, review, set up or close health insurance subrogation claims via phone, fax, email or mail
• Collect, record and verify member information, accident details, attorney information, and liability information
• Record detailed and accurate file notes obtained from calls or written correspondence
• Manage high-volume intake calls and correspondence effectively
• Determine membership eligibility using various job aids and membership systems
• Respond to calls, letters, faxes and emails from policyholders, agents, vendors and/or providers
• Show initiative and resourcefulness in solving problems and meeting customer needs
• Develop relationships with other business units and service partners
• Adhere to company and department policies and procedures as well as HIPAA regulations

Recovery Specialist Associate – Call Center

Medical Director

• partners with National Account’s Sales and Account Management teams
• responsible for providing thought leadership to positively impact healthcare quality, outcomes, and cost
• cultivates relationships with decision-makers and influencers within prospective customers
• serves as a clinical thought leader and develops strategic messaging
• supports account finalist opportunities and client quarterly and annual reviews
• ensures high-quality and efficient medical services are provided to accounts
• serves as the voice of health policy to the clients
• fosters a culture of continuous improvement and best practice sharing in support of clinical models

RVP, Account Management – Medical Director

Operations

• Responsible for operations functions, including coordination between internal departments
• Ensuring the appropriate strategy, tactics, and processes are in place
• Resolves programmatic challenges related to operations including member issues, provider claims issues, contract configuration issues, etc.
• Serves as liaison to Health Plan support services
• Identifies opportunities for Operational Excellence and works to create seamless processes
• Develops and implements key operational indicators for monitoring and analysis
• Serves as a liaison with state regulatory agencies when appropriate

Medicaid State Operations Director

Consultant

• Develops and maintains long-range volume forecasts using historical data, seasonality, benefit cycles, and business drivers
• Builds predictive and scenario-based models to assess demand variability and risk
• Monitors forecast accuracy and continuously refines models using variance analysis
• Translates volume forecasts into headcount, FTE, and skill-mix requirements
• Partners with WFM to align long-range forecasts with short-term scheduling and intraday management
• Supports hiring, backfill, cross-training, and redeployment strategies
• Collaborates with Finance on labor budgeting, reforecasting, and cost optimization
• Provides data-driven insights to inform strategic initiatives, growth planning, and operational changes
• Quantifies workforce impacts of new programs, regulatory changes, or benefit design shifts
• Manages ROI Analysis of pharmacy initiatives impacting workflow and productivity
• Presents forecasts, assumptions, and risks to operational and executive leadership
• Serves as the single source of truth for forward-looking pharmacy demand planning
• Creates clear, executive-level summaries and dashboards
• Provides expertise to lower-level consultants on the analysis of business needs to determine optimal means of meeting those needs
• Determines specific business application software requirements to address the most highly complex and varied business needs
• Leads teams of analysts assigned to the most complex projects, typically those of highest importance and impact to the way in which we do business
• Analyzes and designs solutions to address varied and highly complex business needs.

Senior Long-Range Forecasting Consultant – Pharmacy

Security Engineer

• Integrates geopolitical intelligence and protective intelligence functions, providing both strategic foresight and tactical early warning
• Monitor global political, social, and physical threat landscapes; assess impact on associates, assets, and operations, producing actionable intelligence to inform executive decision-making, travel security, site security, crisis management, and business continuity planning
• Data mines and compiles analytics from various social media platforms
• Develops actionable insights and recommendations from gathered open-source information to support decision-making and provides early warning of physical and operational risks to the company and its leaders
• Support executive protection operations by identifying potential risks to key personnel and recommending mitigation measures
• Develop and deliver written and verbal briefings on geopolitical, regulatory, and global health issues affecting enterprise risk and workforce safety
• Produce analytical reports, scenario analyses, and risk forecasts that translate complex global trends into actionable insights for senior leaders
• Integrate geopolitical data with cyber, supply chain, and regulatory intelligence to evaluate cross-domain risks
• Utilize geospatial and temporal data analytics (ArcGIS, ACLED, Tableau, etc.) to visualize global threat patterns and emerging hotspots
• Collaborate closely with cross-functional partners, including Operations, Executive Protection, Cybersecurity, Business Continuity, Legal, HR, and Corporate Communications to ensure unified awareness and coordinated risk mitigation across the enterprise
• Support crisis response and incident management with analytical insights and intelligence summaries

Security Risk Intel Analyst

• Creates and publishes periodic reports
• Provides analytic consultation to other business areas
• Devises best ways to develop diagnostic and tracking data
• Serves as an expert in data analysis and reporting
• Attends daily stand-up calls
• Communicates and coordinates with other test teams

Business Information Consultant, UAT

Architect

• Creates solutions that articulate the business context, conceptual design, and component-level logical design
• Recommends new technologies based upon business value drivers and return on investment
• Establishes overall systems architecture vision and ensures specific components are appropriately designed and leveraged
• Contributes to the holistic vision of Enterprise Architecture
• Defines architecture standards and anticipates areas where architecture standards may need to be developed
• Directs the construction of architecture components (e.g., data architecture, application architecture, technical architecture)
• Works with business units to translate business strategy into discrete requirements compatible with current technical architecture
• Defines systems, technical, and application architectures for new strategic initiatives
• Develops and maintains an architectural blueprint and evolutionary roadmap that defines and communicates the strategic direction for these architectures

Senior Application Architect – Payment Integrity

• developing and fine-tuning detection logic to identify and alert the team of potential cybersecurity threats
• researching emerging threats and vulnerabilities, performing gap analysis, and curating threat detection Use Cases
• performing capability abstraction based on research of adversarial TTPs and building threat models and detectors
• collaborating with threat hunters and CSOC analysts to validate and tune detection alerts
• developing and implementing advanced detection logic utilizing machine learning algorithms
• engineering and maintaining scalable detection mechanisms across endpoint, cloud, network, and identity environments
• documenting and communicating detection strategies, processes, and findings to stakeholders
• mentoring junior engineers within the team
• ensuring security solutions are well-conceived and implemented in compliance with enterprise standards
• providing technical support to business and technology associates
• overseeing Enterprise mix of vendor services
• acting as key contact for setting vendor strategy

Senior Information Security Advisor – Cyber Detection Engineer

Project Manager

• Manage multiple projects of varying sizes and durations
• Develop resource, risk, quality, cost, and scope management plans
• Develop training plans and requirements documents
• Coordinate requirements, schedules, implementation and post-implementation plans
• Define quality gates for each project methodology phase
• Establish and manage the project warranty period

Senior Project Manager

Customer Support

• Perform case management telephonically and/or through home visits within the scope of licensure for special programs like Foster Care
• Assess and identify appropriate foster home placements considering each child's specific needs and circumstances
• Develop comprehensive care plans to address objectives and goals identified during assessments
• Facilitate pre-placement visits and introductions to help children and families transition smoothly
• Coordinate with internal and external resources to meet the integrated (physical and behavioral) whole person care needs of the member
• Maintain strong relationships with foster families, providing support and guidance throughout the placement process
• Support members' access to appropriate quality and cost-effective care, modifying plans as needed
• Maintain accurate records of placements and communications following organizational and legal requirements

Placement Support Specialist, Region 1

Manager

• Responsible for working with management to identify and implement varied projects, programs and plans that support achievement of business unit and enterprise goals
• Identifies potential issues, project change, and scope
• Leads efforts to identify best practices
• Identifies impacted parties, business partners, and resources required
• Develops and designs processes and systems that support business needs
• Designs methods for integrating function and process
• Conducts cost/benefit analyses
• Builds support for business change throughout the business unit

Senior Business Change Manager

Strategy

• Responsible for business unit strategic planning and customer insight work
• Partner with executive leadership to define strategy and success criteria
• Translate strategy into defined tactics and timelines
• Ensure alignment with the enterprise's strategic plans
• Document strategic priorities and customer insight research initiatives
• Build relationships to provide innovative solutions
• Propose opportunities to improve results
• Development, implementation, and monitoring of planning and project activities

Business Strategy Planning Director

Data Scientist

• Support strategic decision making across the company
• Conduct feasibility analysis for external customers
• Perform commercial analytics by developing predictive models and advanced analytics solutions
• Prepare analytical data sets in support of modeling studies
• Develop and deliver customized reports for a diverse portfolio of clients, ensuring clarity and relevance
• Design and implement scalable analytics pipeline, advanced statistical models to solve business problems
• Conduct exploratory data analysis to support new product development
• Proactively collaborate with business partners to determine identified population segments and develop actionable plans to enable the identification of patterns related to quality, use, cost and other variables