Senior Health Economist - Managed Care at Elevance Health

Walnut Creek, California, United States

Apply Now

Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

NoVisa

HealthcareIndustries

Requirements

MS, MA, or PhD with concentration in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research
Minimum of 3 years direct experience programming large, multi-source datasets with SAS
Minimum of 3 years in health care setting; or any combination of education and experience which would provide an equivalent background
Must be within reasonable commuting distance from office location(s); in-office 1-2 days per week required
Not eligible for visa sponsorship

Responsibilities

Measures financial performance of core Carelon products leveraging claims, authorization, and membership data to tell a detailed story to respective business stakeholders
Creates statistical models to predict, classify, quantify, and/or forecast business metrics
Designs modeling studies to address specific business issues determined by consultation with business partners
Prepares analytical data sets in support of modeling studies
Builds, tests, and validates statistical models
Publishes results and addresses constraints/limitations with high-level business partners
Proactively collaborates with business partners to determine identified population segments
Develops actionable plans to enable the identification of patterns related to quality, use, cost, and other variables

Skills

Key technologies and capabilities for this role

Statistical ModelingPredictive AnalyticsData PreparationClaims Data AnalysisMembership DataAuthorization DataForecastingHealth EconomicsAdvanced Analytics

Questions & Answers

Common questions about this position

What is the work arrangement for this role?

This role requires associates to be in-office 1-2 days per week to foster collaboration, while providing flexibility for virtual work. Candidates must reside within a reasonable commuting distance from an office location, with alternate locations possibly considered.

What are the minimum education and experience requirements?

Requires MS, MA, or PhD in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research, plus a minimum of 3 years programming large, multi-source datasets with SAS and 3 years in a health care setting.

What programming skills are required or preferred?

SAS is required with 3+ years experience programming large datasets. Intermediate to advanced expertise with SQL, SQL Server, Teradata, or equivalent is strongly preferred.

What is the company culture like?

Carelon Health is a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.

What makes a strong candidate for this position?

Strong candidates will have an actuarial sciences background, utilization management experience, expertise in medical economics or healthcare analytics, and comprehensive understanding of medical claims data.

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

Land your dream remote job 3x faster with AI

Try Jobo Free