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Elevance Health · 13 hours ago

Business Consultant - Carelon Payment Integrity

IN-INDIANAPOLIS, 220 VIRGINIA AVE

Full-time

Hybrid

Senior Level, Lead/Staff

8+ years exp

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. The Business Consultant role focuses on utilizing advanced analytics to uncover claims overpayments and guiding clients through the implementation of data-driven insights.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

May lead teams of analysts assigned to complex projects

Determines specific business application software requirements to address complex and varied business needs

Analyzes and designs solutions to address complex and varied business needs

Consults with business partners concerning application and implementation of technology

Lead client consultations to identify and resolve payment integrity issues

Analyze complex claim scenarios and business rules to uncover overpayments

Guide cross-functional teams through the development and implementation of recovery strategies

Design business solutions to address diverse client requirements

Partner with query developers to refine logic based on client data and operational feedback

Facilitate internal and external meetings, ensuring alignment across stakeholders

Document findings, track projects, and manage timelines to successful delivery

Qualification

Business analysisHealthcare claims experienceAdvanced MS ExcelPayment integrityCoding certificationProject managementClient relationsData miningCommunication skillsCross-functional teamwork

Required

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

Prior experience in healthcare claims, payment integrity, or consulting highly preferred

Strong understanding of claims processing, coding practices, reimbursement policies, and payer-provider contracting preferred

Demonstrated ability to work directly with clients and build long-term relationships preferred

Advanced MS Excel capabilities required (pivot tables, VLOOKUP, formulas) highly preferred

Experience leading projects and managing cross-functional stakeholders preferred

Coding certification (e.g., CPC) is strongly preferred

Strong verbal and written communication skills are highly preferred

Ability to translate technical findings into actionable business strategies preferred

Experience with client/vendor relations, customer service, or healthcare analytics a plus

Benefits

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical

Dental

Vision

Short and long term disability benefits

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Company

Elevance Health

Glassdoor3.6

Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.

Founded in 1944

Indianapolis, Indiana, USA

10001+ employees

https://www.elevancehealth.com

H1B Sponsorship

Elevance Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (488)

2024 (604)

2023 (660)

2022 (222)