Hybrid BA II — Medicare Claims & Process Improvement

Business Analyst II – Wellpoint Federal 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. Note: 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. Wellpoint Federal, a subsidiary of Elevance Health, brings deep industry expertise and healthcare service capabilities to support federal programs. Position Summary : The Business Analyst II is responsible for translating basic business needs into application software requirements. How you will make an impact Anaylzes 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. Minimum 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. This position is part of our Wellpoint Federal division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities and Experiences Minimum of 2 years of experience working within a Claims Operations environment. Prior experience supporting Medicare Fee‑for‑Service (FFS) claims processing strongly preferred. Demonstrated understanding of Part A and/or Part B claims workflows, including regulatory requirements, CMS guidance, and CR/TDL implementation processes. Experience responding to external audits, CMS inquiries, compliance requests, and cross‑functional operational initiatives. Proven ability to identify process improvement opportunities and drive standardization across teams. Experience developing or maintaining SOPs, job aids, and centralized documentation repositories. Strong collaboration skills with the ability to work across operational areas (e.g., Clinical Claims, Appeals, Provider Enrollment, EDI, Contact Centers, and other business partners). Ability to analyze operational trends, recommend solutions, and support innovation initiatives within a regulated environment. Comfortable working with data (Excel, basic SQL is a plus) and using tools like Power BI to review and share insights. Foundational understanding of AI capabilities in healthcare and how they can support process improvement or reduce manual work. Additional Information If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a "sensitive position" work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Salary range for this position: $61,680 to $92,520 (depending on location, work experience, education, and skill level). 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, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by applicable federal, state, or local laws. #J-18808-Ljbffr Elevance Health