Investigative Analyst Senior at ELEVANCE HEALTH INC

Lubbock, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

17 Apr, 26

Salary

0.0

Posted On

17 Jan, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Data Analysis, SQL, Statistical Knowledge, Database Development, Data Mining, Predictive Modeling, Business Intelligence, Critical Thinking, Healthcare Analysis, Financial Data Analysis, ETL, Reporting, Collaboration, Training, Problem Solving, Risk Identification

Industry

Hospitals and Health Care

Description

Anticipated End Date: 2026-01-26 Position Title: Investigative Analyst Senior Job Description: Investigative Analyst, Senior Location: 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. The Investigative Analyst, Senior is responsible for analyzing complex business problems and having an extensive knowledge of the applications, data, associated technologies and/or analytic methods to support Department objectives. Analyzes healthcare, business system, and financial data to identify complex patterns of suspicious activity, outliers, anomalies and other issues that represent risk. Displays a high level of critical thinking and analysis. Applies strong knowledge of a structured query language (e.g. MS Access, VBA, T-SQL, or PL/SQL) to perform complex data extraction, quantification, analysis, reporting, and ETL (Extract, Transform, and Loading) of data. Utilizes advanced statistical knowledge to perform sampling, extrapolation and forecasting techniques. Possesses strong demonstrated experience in developing MS Access databases and SQL Server solutions. Works on complex issues where analyses of situations or data require an in-depth evaluation. How you will make an impact: Serves as the point of authority in the analysis of complex healthcare, business systems, and financial data, including development of advanced analytic outputs and/or services. Performs complex data mining and ad hoc data analysis to identify and quantify patterns of suspicious activity, outliers, anomalies and other issues that represent risk. Develops and utilizes complex analytic outputs and/or services, including predictive models, decision trees, forecasting and optimization analysis. Develops requirements for analysis and reporting solutions to support Department business objectives. Develops complex databases, queries, and reports. Perform database and dataset updates. Utilizes multiple corporate data repositories, including SQL Server and Oracle databases to extract information. Uses management reporting tools to provide business intelligence required to make effective decisions. Completes analysis and reporting utilizing a variety of applications (Access, ACL, SQL Server, Oracle, Facets, and PeopleSoft). Reads and interprets design document conceptual, logical, and physical models to include context diagrams, data flow diagrams, process flow diagrams, data dictionaries and logical flow charts. Identifies risks and multiple solutions. Recommends and implements improvements to existing procedures. Influences others to follow existing procedures. Makes technical and functional business recommendations based on evolving technologies and evolving application trends to include infrastructure, software, database, and networks. Analyzes business system configuration data to identify complex patterns of suspicious activity, outliers, anomalies and other issues that represent risk. Addresses business challenges to improve efficiency and decision making, reduce redundancy, and ultimately enhance business results. Applies advanced statistical knowledge to perform sampling, extrapolation and forecasting techniques. Functions as a liaison between own department, health plans, functional areas, and ITS, collaborating directly with associates, other departments, and external constituents to analyze data, identify trends, and communicate findings. Trains associates in data analysis. Serves as a subject matter expert to less experienced associates in data sources, analysis, query, database, application, and reporting. Continues to improve technical skills and to stay current with changes in corporate data resources, company initiatives/objectives, tools and applications. Minimum Requirements Requires a BA/BS in computer science, finance, economics, statistics, mathematics, business administration, information systems, operation research, accounting or related analytical discipline and minimum of 3 years related experience in statistics, actuarial analysis or medical profiling; or any combination of education and experience, which would provide an equivalent background. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: FRD > Investigation 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 may contact elevancehealthjobssupport@elevancehealth.com for assistance. 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. Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading. Join our Talent Community and stay connected with company news, information, and future job opportunities. Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner. Our nearly 100,000 associates serve approximately 100M+ people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health. Please visit the Contract Worker Community Page. Elevance Health is an Equal Opportunity Employer/Disability/Veterans.

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Responsibilities

The Investigative Analyst, Senior is responsible for analyzing complex healthcare, business systems, and financial data to identify patterns of suspicious activity and other issues that represent risk. This role involves developing advanced analytic outputs and services to support departmental objectives.