Senior Health Economist - Managed Care

Location

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.

PLEASE NOTE:

This position is not eligible for current or future visa sponsorship.

The Senior Health Economist measures financial performance of core Carelon products leveraging claims, authorization, and membership data to tell a detailed story to respective business stakeholders. The Senior Health Economist creates statistical models to predict, classify, quantify, and/or forecast business metrics. Design modeling studies to address specific business issues determined by consultation with business partners.

• Prepares analytical data sets in support of modeling studies. Build, test, and validate statistical models.
• Publishes results and addresses constraints/limitations with high-level business partners.
• Proactively collaborates with business partners to determine identified population segments.
• Develop actionable plans to enable the identification of patterns related to quality, use, cost, and other variables.

• Requires MS, MA, or PhD with concentration in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research, a minimum of 3 years direct experience programming large, multi-source datasets with SAS required, and a minimum of 3 years in health care setting; or any combination of education and experience which would provide an equivalent background.

• Actuarial sciences background highly preferred.
• Utilization Management experience preferred.
• Medical economics, provider finance, healthcare analytics, and/or financial services highly preferred.
• Comprehensive understanding of medical claims data.
• Intermediate to Advanced expertise with SQL, SQL Server, Teradata, or equivalent strongly preferred.
• Proven ability to design modeling studies and experience with data models, addressing data quality issues in study design, and constructing robust and efficient analytical data sets strongly preferred.
• Significant experience in a healthcare-related field strongly preferred.
• The ability to present meaningful results to a business audience, to participate collaboratively in a team tasked to produce complex analyses on a rigorous schedule, to communicate with strong written and verbal communication skills, and to present to large multi-disciplinary audiences regularly strongly preferred.

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.

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.

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,…