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Anthem, Inc. Clinical Programs Director in Waukesha, Wisconsin


SHIFT: Day Job

SCHEDULE: Full-time

The clinical department of the Anthem health economics division is dedicated to helping individuals to gain greater value from their health plan, their doctors and the health dollars they spend. We blend technology and data analysis to improve the safety, quality and coordination of health care services, helping to lower costs.

  • Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.

  • Use data-driven approaches to identify opportunities and develop analytic solutions to improve quality of care, health, and contain healthcare cost across the continuum of care, various population segments, and multitude of intervention designs.

  • Employ empirical estimation approaches to gain critical insights into member behavior drivers and preferences, product/program concepts and value propositions, operational effectiveness and efficiencies, client specific health gaps and needs.

  • Consult business leaders and internal partners to apply the insights to test and drive product innovation and enhancement, to target the right members for the right service, to demonstrate value, and to support information based strategic decision making.

    Primary duties may include, but are not limited to:

  • conduct in-depth research to address challenging issues in measuring outcomes;

  • lead applied research projects;

  • provide analytical insights to support business solution development based on quality, use, cost and other key drivers;

  • apply behavioral economic principles to the understanding of population health challenges, and the design of effective, economical interventions;

  • quantify economic implications of programs to improve population health status;

  • relate priorities and drivers of corporate divisions of actuarial science and health economics, focusing on aspects pertinent to population health status;

  • develop and refine analysis templates for problem diagnosis and opportunities assessment;

  • consult on all considerations related to designing and executing tests or pilot programs;

  • contribute to the design of new program/initiative based on test/pilot outcomes;

  • develop targeting criteria or customer segmentation based on economic insights, clinical inputs, product design and operations considerations;

  • develop methodology to measure financial, clinical and utilization program/initiative performance


Strongly prefer a degree and/or experience in a quantitative discipline such as applied economics, public health, epidemiology, actuarial science, mathematics, statistics, engineering, computer science or operations research; 5+ years’ hands-on experience in related health care analytics. Experience with developing expert modeling systems for segmentation/stratification that supports customized strategies for different customer segments in a major industry highly desirable - healthcare, financial, consulting, etc. Substantial analytical experience in healthcare industry preferred. Advanced expertise with R, Python, SQL, or equivalent analytical tools. Requires a Bachelor’s degree in a related clinical area, nursing or other; 6 years of related experience including program development and clinical economics; or any combination of education and experience, which would provide an equivalent background.

Applicable to Colorado Applicants Only

Annual Salary Range*: $107,200 - $134,000

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

  • The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

    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. An Equal Opportunity Employer/Disability/Veteran.

    Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.

    REQNUMBER: PS54494-Pewaukee