Risk Adjustment Systems Analyst Advisor
Elevance Health
Position Overview A key member in our Medicaid renal/ESRD strategy area for both our Health plans and vendors. Under the direction of the Medicaid RA Director, they will play a key role in both Specialty Revenue [ESRD] as well as Risk Adjustment. How You Will Make an Impact Defines functional, usability, reliability, performance and support requirements of a system Creates and performs feature testing and determines environmental needs Provides the link between the technical and business views of the system by ensuring that the technical solutions being developed will satisfy the needs of the business Partners with business, architecture and infrastructure and oversees all service levels to ensure business area satisfaction In depth knowledge of tools utilized Works with the IT learning organization to mentor and assist in training initiatives and performs estimates for application functionality enhancements Proactively works with stakeholders to identify future system opportunities and enhancements Develops use cases Required Qualifications Requires a BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years experience in a variety of technologies, documenting requirements and/or building test cases; or any combination of education and experience, which would provide an equivalent background. Preferred Qualifications Medicaid experience is a must Business Analyst or Business Systems Analyst certifications strongly preferred Experience with mainframe computer, hardware and operating systems and the impacts of changes in the systems stream, testing/product quality processes, tools and methods strongly preferred Experience with Rational tools, Six Sigma or other process improvement training strongly preferred Benefits 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. Location Indianapolis IN, Mason OH, Atlanta GA, Tampa FL, Grand Prairie TX, Louisville KY, St. Louis MO Hours Standard Working hours Travel 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. Equal Employment Opportunity 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 View email address on click.appcast.io 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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration ( #J-18808-Ljbffr
- ...both Specialty Revenue [ESRD] as well as Risk Adjustment. How You Will Make an Impact:... ...performance and support requirements of a system Creates and performs feature testing... ...Medicaid experience is a must Business Analyst or Business Systems Analyst...RiskTemporary workWork at officeLocal area2 days per week1 day per week
- ...both Specialty Revenue [ESRD] as well as Risk Adjustment. How You Will Make an Impact Defines... ...and support requirements of a system Creates and performs feature testing and... ...Medicaid experience is a must Business Analyst or Business Systems Analyst certifications...RiskTemporary workWork at officeLocal area2 days per week1 day per week
- ...law. Position Overview: Responsible for leading the development of new business plans/strategies for Government Business Risk Adjustment initiatives. Responsibilities will include Medicaid specific risk adjustment and specialty revenue assignments; Medicare Advantage...RiskTemporary workWork at officeLocal area2 days per week1 day per week
- ...Elevance Health is seeking a Systems Analyst Advisor in Grand Prairie, Texas. This position blends in-office collaboration with the flexibility of virtual work. The successful candidate will define the scope of Business Systems projects and ensure alignment between technical...SuggestedWork at office
- ...reporting Analyze and resolve undistributed adjustments and assess impact to the general ledger... ...to identify discrepancies, trends, and systemic reporting issues Support financial... ...audit readiness Advise leadership on FBwT risks, findings, and corrective action strategies...RiskWork at officeFlexible hours
- ## Risk Management SpecialistApplylocations: Irving-Irving Corporate Office-3939 West John... ...* Assists in daily internal claim system date update**Other duties as assigned****... ...Experience the Job Requires*** Multi-Line Adjuster license* 3+ years of multi state retail claim...RiskFull timePart timeWork at officeLocal area
- ...Quanta Services, Inc. is seeking a Claims & Risk Manager in Grand Prairie, Texas. This role involves leading the incident-to-claim lifecycle and collaborating with safety teams to manage claims effectively. You will be responsible for evaluating incidents, ensuring documentation...Risk
- ...NorthStar Energy Solutions, LLC in Grand Prairie, TX is seeking a Claims & Risk Manager to lead the incident-to-claim lifecycle. You will work with safety and risk teams, ensuring proper documentation, investigating incidents, and delivering optimal claim outcomes. The...Risk
- ...University of Texas at Arlington is looking for an IT Performance and Risk Management Manager to establish best practices in aligning IT... ...will have a Bachelor’s degree and extensive experience in IT systems governance, risk management frameworks, and familiarity with tools...RiskFull time
- ...Overview The Risk Manager at Berkshire Hathaway Automotive will develop and administer organization-wide risk management programs while... ...and business partners. Flexibility and good judgment - easily adjust priorities and workflow based on needs. Self-starter with the ability...RiskWork at office
- ...clinical setting. This role emphasizes building strong relationships with key leaders and conducting audits to mitigate compliance risks. Ideal candidates will hold a BA/BS degree and possess at least 8 years of relevant experience in healthcare compliance. Registered...Risk
$117.19k
...IT Performance and Risk Management Manager Position Title: IT Performance and Risk Management Manager Department: OIT Performance &... ...plan for IT Asset Management. Establish policies, processes, and systems for asset management. Manage lifecycle of hardware and software...RiskFull timeMonday to Friday- ...Living Spaces is seeking a Safety & Risk Manager to spearhead safety initiatives at our Grand Prairie distribution center. The role involves developing safety programs, conducting audits, and partnering with leadership to enforce safety policies. The ideal candidate will...RiskWork experience placement
- ...Position SummaryThe Safety & Risk Manager, will be responsible to lead and develop safety points of contact and committees within a... ...warehouse operations and ergonomics. In-depth knowledge of such systems as OSHA, environmental law and health and safety at work state and...RiskHourly payFull timePart timeWork experience placementLocal areaWork from homeShift workNight shift
- ...Financial Advisor Job Duties: Serves as an advisor to provide an advice-based approach to financial solutions for an assigned book of business... ...protect bank interests.Understands and adheres to the company's risk and regulatory standards, policies, and controls. Maintains...Risk
- ...Governance, Risk, and Compliance Manager Irving, TX Meriton is a national team of... ...companies. From strategy and support to systems and solutions, we work behind the scenes... ...vision, depth perception, and ability to adjust focus. Acknowledgment: I have read...RiskWork at officeRemote workWork from home
$117.19k
...Number S06859P Position Title IT Performance and Risk Management Manager Department OIT Performance & Risk... ...proactive compliance monitoring in alignment with the University, UT System, and State policies. Advises and educates IT leadership and...RiskFull timeFor contractorsMonday to Friday- ...planning and investment advisory services. Research and present investment strategies. Develop and execute retirement planning. Implement risk management and tax planning strategies. Coordinate estate planning. Manage client relationships. Identify and cultivate new clients....Risk
$119.77k - $140.9k
...Manager (APM) position supports the Model Risk team within Corporate Audit Services (... ...and schedule. Includes making necessary adjustments and promptly completing work paper reviews... ...of products, services, and delivery systems; company policies and procedures; applicable...RiskTemporary workWork experience placement3 days per week- ...EMS Systems Analyst Tenaska is one of the largest privately held companies in the United States, an organization that's adept in natural... ...scalable solutions that reduce manual effort and operational risk Support the development of intelligent automation, decision...RiskFor contractorsWork experience placementLocal areaRemote workWork visaFlexible hours
- ...data analytics to assess financial reporting accuracy andidentify systemic issues Support and advise on FBwT-related policy interpretation and reconciliationimplications Evaluate financial reporting risks and recommend corrective actions alignedwith FMR guidance Direct...RiskWork at officeFlexible hours
$31 - $41 per hour
...employees across the organization. As an HRIS Analyst I, you will play a key role in supporting... ...through reporting, data analysis, and system support. You will work closely with HR,... ...identify trends, discrepancies, compliance risks, and improvement opportunities. Apply...RiskHourly payWork at office$83k - $132k
...with monitoring and administration of a budget. Minimize legal risk to the Conservancy and ensure legal compliance with applicable state... ...Microsoft and Google applications (Word processing, Excel), CRM systems, etc. Experience working with teams across organizations....RiskLocal areaFlexible hours- ...Meriton, LLC. is seeking a Governance, Risk, and Compliance Manager based in Irving, TX. This role supports the organization’s information security and enterprise risk management programs, ensuring compliance and risk mitigation. The ideal candidate will have a Bachelor...Risk
$80k - $153k
...Job Description: Manager, Asset Management Risk (Crypto) Note: Fidelity is not providing immigration sponsorship for this position. The Role The Manager, Asset Management Risk (Crypto) is responsible for delivering operational risk oversight for Fidelity...RiskWork experience placementWork from homeShift work$130k - $234k
...bodies (Fed, FINRA, SEC, OCC, FRB, FinCen, etc.). Collaborate with client functions (Business, First Line of Defense, Compliance Risk Management, Regulatory Affairs) to assess regulation impact on existing policies, risks, and controls. Develop data maps to meet...RiskTemporary workWork experience placementWork at officeLocal areaRelocation- ...Trophy Nissan in Irving, TX is looking for a Risk Manager to develop and administer risk management programs while evaluating potential risks for its automotive dealerships. The ideal candidate will have a Juris Doctorate or a Bachelor's degree in a related field with...Risk
- ...with monitoring and administration of a budget. Minimize legal risk to the Conservancy and ensure legal compliance with applicable state... ...Microsoft and Google applications (Word processing, Excel), CRM systems, etc. Experience working with teams across organizations....RiskLocal areaFlexible hours
- ...completion. Monitor and track project progress, identifying potential risks and implementing mitigation strategies. Track and manage... ...budgets, tracking expenditures to identify variances and adjust plans accordingly. Forecast project end dates and resource requirements...RiskTemporary workFor subcontractor
$80k - $110k
LVMH Group is looking for a Fraud Manager, Client Services in Irving, Texas. The successful candidate will oversee fraud prevention efforts, lead a dedicated team, and collaborate with internal and external stakeholders to improve compliance. With a salary ranging from...Risk
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Risk Adjustment Systems Analyst Advisor. Be the first to apply!



