Title: Grievances & Appeals Risk Analyst II

Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.

The Grievances & Appeals Risk Analyst II will be responsible for providing support services for multiple states, enterprise-wide functions and/or complex issues through complex assignments and projects, which utilize recognized areas of specialization and knowledge specific to the company.

How you will make an impact:

• Prepares, analyzes and evaluates written correspondence such as complaints, grievances, document demands, alleged ERISA violations and researches to resolve problems and close outstanding issues at the state or enterprise level.

• Conducts research and analysis, recommends appropriate course of action and next steps.

• Performs fact checking, gathers documents, researches and responds to records requests, and various inquiries from internal and external sources, coordinates investigative and discovery activities specific to Grievance and Appeal functions.

• Assists with compliance issues as needed.

• Attends and represents Grievances & Appeals at appropriate legal proceedings and arbitration hearings under supervision of counsel.

• Participates on projects and may participate in negotiations and strategizing with business and staff.

• Enters information as required into appropriate databases or other document management systems.

• May serve as a resource to other support staff.

Minimum Requirements

• H.S. diploma

• Minimum of 5 years of related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications

• BA/BS in a related field is preferred.

• Paralegal certification and experience preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $29.24/hr. to $43.86/hr.

Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable

policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.