Business Analyst II- Capitation

Elevance Health • Atlanta, VA

6d • Hybrid

About The Position

The Business Analyst II- Capitation is responsible for translating basic business needs into application software requirements. 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. Primary duties may include, but are not limited to: 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.

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.

Benefits

• a comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• 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 and financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level