Anthem HEDIS Business Info Consultant PS7569 in Norfolk, Virginia

HEDIS Business Info Consultant PS7569


Location: United States

Field: Reporting & Data Analysis

Requisition #: PS7569

Post Date: 5 days ago

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater 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.

Business Information Consultant

Position may be located at any Anthem location or work from home.

Successful candidate should have HEDIS experience including: Medicare, data transformation, analyses, knowledge of supplemental data, audit processes, and applying data quality processes.

Responsible for understanding various processes and data streams which amasses information from a number of data sources into centralized databases.

Requires ability to support changes to these processes as driven by business needs which entails working with internal customers, team, and software vendors, and IT support team to define business requirements, conduct user acceptance testing and production verification of these changes.

In some cases, modification of internal processes requires technical expertise in DDL (data definition language) as well as experience in ETL processes, specifically SSIS.

Also responsible for loading data, running processes and producing reports in HEDIS reporting software.

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, 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.

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.

  • 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, mentoring staff in lower job levels, 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.

  • Managed care is preferred.

  • Access is required.

  • SQL is a required.

  • Knowledge of HEDIS is a plus.

  • Data analysis of healthcare claims data is strongly preferred.

  • Experience with HEDIS reporting software, experience in writing and executing SQL queries to analyze and validate data and experience in focused analytic consultation and customer collaboration required.

  • Strong communication skills required and customer focused approach. Experience with implementations and managing technical requirements required.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2016 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran.