Business Analyst II- Capitation

Elevance Health•Indianapolis, IN

2d•$61,680 - $92,520•Hybrid

About The Position

The Business Analyst II- Capitation is responsible for translating basic business needs into application software requirements. This role supports multiple markets, serving as the primary analyst and assisting the health plan with provider questions, payments, and contract concerns. The position involves configuring capitation for new contracts, amendments, and updates, and leading policy development and implementation of behavioral health reimbursement policy rules. It also includes testing new implementations, new business, and expansions, while learning basic GCP concepts and other capitation-related processes. The analyst will determine specific business application software requirements to address business needs and work with programming staff to ensure requirements are incorporated into system design and testing, acting as a liaison with users of the software to address questions/issues.

Requirements

BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Knowledge of systems capabilities and business operations is strongly preferred.
Experience with GBD Facets capitation configuration and healthcare operations.
Knowledge of provider contracts, amendments.
Strong Excel skills (pivots, formulas, Power Query).
SQL skills for data analysis.
Ability to perform trend analysis and identify overpayment patterns and false positives.
Effective communication and collaboration with cross-functional partners.
May represent the department in meetings.

Responsibilities

Analyze and support multiple markets, serving as the primary analyst and assisting the health plan with provider questions, payments, and contract concerns.
Configure capitation for new contracts, amendments, and updates, and lead policy development and implementation of behavioral health reimbursement policy rules for specific plan(s).
Test new implementations, new business, and expansions, while learning basic GCP concepts and other capitation-related processes.
Analyzes business needs to determine optimal means of meeting those needs.
Determines specific business application software requirements to address specific business needs.
Works with programming staff to ensure requirements will be incorporated into system design and testing.
Acts as liaison with users of the software to address questions/issues.