Anthem Inc. Medical Jobs

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Anthem, Inc. Business Information Analyst Senior/Consultant in Lexington, Kentucky

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.

Preferred Location - Illinois, Indiana, Kentucky, New York, Ohio, Georgia

Please note this positon can be filled at either the Bus Info Analyst Sr or Consultant Level. Level determined at Hiring Manager's discretion

This position is responsible for the design, maintenance and measurement of Anthem’s provider networks, in addition to assessing the competitiveness of our provider contracts; critical activities that support key enterprise goals related to High Performance Networks (HPNs) and unit-price trend targets.

Responsible for serving as an expert in data analysis, reporting and formulating recommendations with core focus in the network and competitive intelligence space. Primary duties may include, but are not limited to:

  • Analyzes data and summarizes performance using summary statistical procedures to inform provider selection in new network designs and quantify changes in cost, quality and access for alternative network designs.

  • Develops and analyzes business performance reports on the performance of provider networks and contracts; providing notations of performance deviations and anomalies.

  • Creates and publishes periodic reports, as well as any necessary ad hoc reports.

  • Creates and maintains databases to track business performance.

  • May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

  • May make recommendations based upon data analysis to customers, business partners and other team members.

  • Provides analytic consultation to other business areas, leadership or external customers.

  • Data analysis and reporting encompasses a much higher level of complexity.

Qualifications

  • Requires a BS/BA degree in related field; minimum of 5 years experience; or any combination of education and experience, which would provide an equivalent background.

  • Experience with relational databases, knowledge of query tools and statistical software, along with ability to manipulate large sets of data is required.

  • Strong analytical, organizational, presentation and problem solving skills are required.

  • SQL experience required.

  • SAS and Python experience preferred.

  • Master's degree preferred.

  • In-depth knowledge of evaluating provider network performance from a cost and quality standpoint preferred.

  • In-depth knowledge of provider profiling methodologies to evaluate cost and quality (i.e. case-mix adjusted cost per service, ETG, DxCG) preferred

  • In-depth knowledge of Medicare and Medicaid reimbursement methodologies preferred.

  • Experience in analyzing Coordination of Benefit (COB) data preferred.

  • In-depth knowledge of recent CMS Price Transparency regulations preferred.

The Business Info Consultant role is more focused on higher level technical expertise, mentoring staff in lower job levels, more customer facing activities, higher level of collaboration, higher volume and/or higher complexity modeling as compared to the Bus Info Analyst Sr job.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

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. An Equal Opportunity Employer/Disability/Veteran

REQNUMBER: PS44415-Kentucky

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