Systems Analyst Advisor - Commercial Reinsurance
- Lead the end-to-end Commercial Reinsurance data and CMS submission process, ensuring timely, accurate, and compliant submissions.
- Evaluate, redesign, and optimize existing Reinsurance workflows to improve efficiency, scalability, automation, and data quality.
- Design and implement automated end-to-end processes that reduce manual effort and improve operational performance.
- Identify claims eligible for Commercial Reinsurance by analyzing claims, membership, and other enterprise data sources.
- Work across multiple data sources, including claims systems, operational applications, enterprise databases, and data warehouses, to support business and regulatory requirements.
- Develop, maintain, and optimize complex SQL and SAS programs for data extraction, validation, reconciliation, and regulatory reporting.
- Perform deep-dive analysis to investigate data discrepancies, identify root causes, and recommend sustainable solutions.
- Support CMS submissions, CMS inquiries, and federal audits through comprehensive data analysis and documentation.
- Support User Acceptance Testing (UAT) for enhancements, production releases, and projects impacting Reinsurance submissions.
- Analyze business and system changes, assess impacts to the Reinsurance process, and implement effective technical solutions.
- Support migration of legacy SQL and SAS processes to Snowflake and other modern cloud-based technologies.
- Collaborate with business partners, IT, and external stakeholders while independently leading analytical efforts and recommending technical solutions.
- Continuously identify opportunities to automate, modernize, and improve business processes and data workflows.
- Document business processes, technical designs, data flows, and operational procedures.
- Requires an 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.
- Experience supporting Commercial Reinsurance or CMS Reinsurance programs.
- Claims processing, claims data analysis, or healthcare claims experience is highly preferred.
- Experience identifying claims eligible for CMS regulatory programs.
- Experience supporting CMS submissions, CMS inquiries, and federal audits.
- Experience with Snowflake and cloud-based data warehouse technologies.
- Experience migrating SQL, SAS, or ETL processes to Snowflake, Python, Spark/Snowpark, or similar cloud platforms.
- Experience with Microsoft SQL Server.
- Experience with enterprise data warehouses, ETL processes, data governance, and data quality best practices.
- Experience leading process improvement, workflow redesign, and automation initiatives.
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 [email protected] 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.
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 [email protected] 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
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