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Anthem, Inc. Medicare Risk Adjustment (MRA) Data Scientist in Des Moines, Iowa


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.

The Medicare Risk Adjustment (MRA) Data Scientist is responsible for the development and implementation of predictive modeling algorithms and techniques to solve business problems and optimize member experiences. Primary duties may include but are not limited to:

  • Design predictive modeling projects to address specific business problems determined by consultation with business partners.

  • Work with data-sets of varying degrees of size and complexity including both structured and unstructured data.

  • Piping and processing massive data-streams in distributed computing environments such as Hadoop to facilitate analysis.

  • Implements batch and real-time model scoring to drive actions. Develops proprietary algorithms to build customized solutions that go beyond standard industry tools and lead to innovative solutions.

  • Develops proprietary algorithms to build customized solutions that go beyond standard industry tools and lead to innovative solutions.

  • Develop sophisticated visualization of analysis output for business users.

  • Provides high-level controllership/evaluation of all output produced to ensure established targets are met.

  • Determines the continuous improvement opportunities of current predictive modeling algorithms.

  • Proactively collaborates with business partners to determine identified population segments and develop actionable plans to enable the identification of patterns related to quality, use, cost and other variables.


Minimum Requirements

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid-19. All offers of employment are conditioned on completion of a background check, including COVID-19 vaccination verification. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.

Requires a Bachelor’s degree in Statistics, Computer Science, Mathematics, Machine Learning, Econometrics, Physics, Biostatistics or related Quantitative disciplines and 3 or more years experience in predictive analytics, or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications

  • Masters and experience in the Medicare sector preferred.

  • An ideal candidate will have: Extensive experience in working with Medicare Risk Adjustment data; Risk Adjustment Processing System (RAPS), Encounter Data Submissions (EDS), Medicare Provider Data, ICD-10, Hierarchical Condition Category (HCC), etc. , experience with Data Governance work related to Encounter and RAPS processing.

  • Advanced expertise with software such as Python, R, SAS, SAS Enterprise Miner or equivalent is strongly preferred.

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 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.