Anthem, Inc. Provider Contract/CofC Analyst Sr – Clinical Solutions Finance - PS34771 in Downey, 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 benefits companies and a Fortune Top 50 Company.
Provider Contract/CofC Analyst Sr – Clinical Solutions Finance - PS34771
Location: Virginia Beach, VA preferred; will consider other locations
Provides analytic support to both a regional Finance and Enterprise areas. Focuses efforts on analyzing, reporting and developing recommendations on data related to multiple, varied business metrics. Provides analytic support to Finance Leads, Medical Directors, clinical staff and Enterprise partners.
Primary duties may include, but are not limited to:
· Analyzes and presents data related to medical trends in coordination and collaboration with Finance and Enterprise partners. Summarizes performance using appropriate analytics and tools. Develops business performance reports using claims data that tells the drivers behind medical trends. Creates and publishes standard and ad hoc reports.
· Performs varied data analyses which may include: performing healthcare cost analysis to identify strategies to control costs; projecting cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis; performing modeling to compare various contract scenarios based on member utilization patterns and 'what if' logic; measuring and evaluating the cost impact and projecting different savings targets based upon various analytics.
· Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures and recommends policy changes and claim's system changes to pursue cost savings. Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable. Recommends standardized practices to optimize cost of care.
· Participates on project teams involved in regional and enterprise wide initiatives.
· Requires ability to write SQL queries and have advanced Excel skills. Must have experience manipulating large relational databases. Experience with healthcare data preferred.
· Requires BS/BA degree in Mathematics, Statistics, or related field; 3-5 years’ experience in broad-based analytical, managed care payor or provider environment; experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background.
· Master's degree preferred.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc. magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at Careers.antheminc.com