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Business Consultant Sr- Data Mining Overpayment and Operations/Payment Integrity- WGS Claims

Elevancehealth
IN-INDIANAPOLIS, 220 VIRGINIA AVE Senior Full-time

Anticipated End Date:

2026-07-17

Position Title:

Business Consultant Sr- Data Mining Overpayment and Operations/Payment Integrity- WGS Claims

Job Description:

Business Consultant Sr 

Location: Indianapolis, IN

Hybrid 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.

Shift: Shift: Monday – Friday Daytime hours

The Business Consultant Sr  position is responsible for leading a team of analysts and consultants that are responsible for translating complex and varied business needs into business cases or business requirements documents (BRD) to create machine learning models or data mining queries that will contribute to cost of care savings. These needs typically involve significant expenditure or cost savings and impact a wide range of functions. Also, provides expertise to lower leveled consultants.  

How you will make an impact: 

Primary duties may include, but are not limited to:  

  • 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.  

  • Will lead a team 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.   

  • Partnering closely with data scientists, query developers and business owners in the execution of machine learning models by providing feedback during various phases. 

  • Managing and prioritizing work assignments based on business needs 

  • Travels to worksite and other locations as necessary. 

Minimum Requirements: 

  • Requires a BA/BS and minimum of 10 years business analysis experience, which should include analysis, project management, working knowledge of mainframe computer, hardware and operating systems; minimum of 3 years experience as a Business Consultant with project management skills; or any combination of education and experience, which would provide an equivalent background.  

Preferred skills:  

  • Machine learning understanding and experience 

  • Strong analytical and problem-solving skills with research-oriented approach 

  • Strong written, verbal and interpersonal communication skills  

  • Advanced skill level with MS Excel; pivot tables, formulas, V-lookup, etc. 

  • Strategic thinking and collaboration skills 

  • Claims processing skills 

Job Level:

Non-Management Exempt

Workshift:

Job Family:

BSP > Business Support

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. 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.


Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.


NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.

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