Business Analyst / Product Analyst Position Available In Fulton, Georgia

Business Analyst / Product Analyst

Title:

Business Analyst / Product Analyst Risk Adjustment (Healthcare Payor)

Location:

Richmond, VA or Atlanta, GA (Onsite Preferred)

Client:

IBM / Elevance Health

Rate:

$45/hr

Note:

Prior Elevance Health experience is strongly preferred

Job Description:

We are seeking an experienced Business Analyst / Product Analyst with a strong background in Risk Adjustment processes for a healthcare payor environment. The ideal candidate will have deep domain expertise in the revenue cycle, claims, and coding practices and be comfortable working cross-functionally with medical and technical teams. Candidates with prior experience at Elevance Health are highly preferred.

Key Responsibilities:

Analyze existing risk adjustment methodologies to identify gaps
, missed opportunities, and data inconsistencies.
Support the development and maintenance of alternative submission methods to improve coding accuracy and recapture missed revenue
.
Partner with medical directors, clinical teams, and coding specialists to deliver education and process improvements
.
Monitor and analyze large datasets to identify trends, anomalies
, and opportunities in risk adjustment performance.
Provide strategic insights to stakeholders to enhance risk adjustment workflows and data submissions.
Document processes, workflows, and improvement plans aligned with business objectives.

Required Experience:

Strong background in healthcare payor environments
, specifically with Risk Adjustment and revenue cycle processes.
Hands-on experience working with risk coding data, HCC coding, and alternative submission models.
Skilled in data analysis
, trend identification
, and reporting using healthcare data.
Proven ability to collaborate cross-functionally with clinical and business stakeholders.
Excellent written and verbal communication skills for stakeholder presentations and documentation.

Preferred Qualifications:

Prior experience working at Elevance Health (strongly preferred).
Experience in Medicare Advantage
, Medicaid, or ACA plans.
Familiarity with risk adjustment models
, coding guidelines (ICD-10, HCC), and CMS regulations.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
Report this job

Dice Id:

91166107

Position Id:

8680683