Anthem Bus Info Analyst II/ Analyst Sr Norfolk, VA PS10284 in Norfolk, Virginia

Bus Info Analyst II/ Analyst Sr Norfolk, VA PS10284

Location: Norfolk, Virginia, United States

Field: Reporting & Data Analysis

Requisition #: PS10284

Post Date: Aug 08, 2018

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 atone of America's leading health benefits companies and a Fortune Top 50 Company.

This position focuses on individual markets and implementing the EDIFECS solution and business process changes required for the market. The business information analyst will generally be involved in capturing and/or developing documentation reflecting the current state for Encounters processing, operations, and submissions, translating into future state processes based upon in-depth knowledge of the EDIFECS platform and the Medicaid/Medicare Encounters processing function. This includes guiding operational business and technical teams in defining processes, translating processes into requirements, developing guidelines, policies, and procedures, identifying transitional activities and developing market specific cutover strategies.

The Business Info Analyst II is responsible for analyzing, reporting and developing recommendations on data related to multiple, varied business metrics. Primary duties may include, but are not limited to:

  • 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.

  • Creates and publishes periodic reports, makes necessary recommendations, and develops ad hoc reports as needed. 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.

The Business Info Analyst Sr is responsible for analyzing, reporting and developing recommendations on data related to complex and varied business metrics. Typically provides technical assistance to lower level staff. Primary duties may include, but are not limited to:

  • Creates and maintains databases to track business performance.

  • Analyzes data and summarizes performance using summary statistical procedures.

  • Understand performance measurement, e.g. rejection threshold edits for market(s) and impact to market contractual metrics

  • Perform data analysis and data sampling to identify issues and spot trends as related to pends, rejects, and remits

  • Accurately translate state encounters requirement and document these into business requirements and test plans

  • Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.

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

  • 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.

Requirements Info Analyst II:

  • a BS/BA degree in related field;

  • 2-4 years related operational and/or data analysis experience; experience in database structures, and standard query and reporting tools; or any combination of education and experience, which would provide an equivalent background.

  • This job is more focused on technical expertise and analysis as compared to the Bus Info Analyst I job.

Requirements Info Analyst Sr:

  • Requires a BS/BA degree in related field; 3-5 years data analysis or related 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.

  • Experience with transaction data sets,

  • Ability to manipulate large sets of data is also required.

  • Strong analytical, organizational and problem solving skills.

  • This job is focused on complex and varied metrics, making recommendations and providing assistance to staff as compared to the Bus Info Analyst II job.

Additional Requirements for both levels:

  1. Knowledge of Healthcare claims / encounters processing

  2. Good understanding of Healthcare reforms and regulatory framework preferred

  3. Good understanding of Medicaid and regulatory framework preferred

  4. Understanding of EDI transactions including X12 and UN/EDIFACT ; HIPAA preferred

  5. Experience in interpreting requirements and developing functional specifications

  6. Strong problem analysis, problem-solving, and analytical skills required

  7. Strong analytical and product management skills required, including a thorough understanding of how to interpret customer business needs and translate them into application and operational requirements required

  8. Understanding of Healthcare transactions - HL7 and NCPDP

This position must sit in Norfolk, VA.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.