Anthem, Inc. Business Information Consultant in Rancho Cordova, California
SHIFT: Day Job
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.
Responsible for serving as an expert in data analysis, SQL, data intake/transformation and formulating recommendations. Analyzes member and measure level HEDIS data and summarizes performance using available SQL tools and summary statistical procedures. Develops and analyzes business performance analyses and reports (e.g. for claims data, provider data, utilization data) and prepares data for HEDIS reporting purposes.
Remote opportunity - Preferred locations - Georgia, Indiana, Virginia, California, New York, Illinois, Ohio, Wisconsin, Florida.
Primary duties may include, but are not limited to:
Supporting project deliverables to review, test, and provide UAT findings and recommendations on measure testing and implementation for increased frequency of Medicare HEDIS measure sets runs.
Complete pre-engine queries, data audits and engine runs for the Medicare population. Evaluate all data files to include all ETL and supplemental data files to ensure data has been included as expected for UAT, and engine runs.
Run Cotiviti Quality Engine to support production of Medicare more frequent HEDIS measure results.
Creates and publishes periodic reports, as well as any necessary ad hoc reports.
Project lifestyle tracking and ability to clearly communicate and escalate issues to management.
Creates and maintains databases to track business performance.
Analyzes data and summarizes performance using summary statistical procedures.
Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.
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.
Provides analytic consultation to other business areas, leadership or external customers.
Data analysis and reporting encompasses a much higher level of complexity.
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 and knowledge of query tools and statistical software is required (SQL, SAS, Teradata). Medicare HEDIS experience is preferred. Knowledge of HEDIS and value sets and specifications experience. Cotiviti Software experience preferred. Provider data Experience. Ability to manipulate large sets of data. Strong analytical, organizational, presentation, and problem solving skills. This job is more focused on higher level technical expertise, more customer facing, higher level of collaboration, work is higher volume and/or higher risk, and modeling as compared to the Bus Info Analyst Sr job.
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.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.