MyPage is a personalized page based on your interests.The page is customized to help you to find content that matters you the most.


I'm not curious
1

Business Information Consultant

Location Norfolk, United States
Posted 10-September-2021
Description
Description
SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were 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 Americas leading health care companies and a Fortune Top 50 Company.

We are currently seeking a Business Information Consultant to support the Concept Development and Prepay team within Anthems Program Integrity Analytics Unit.

As a successful individual on this team, you will work with key business partners to accomplish assigned goals that may include, but will not be limited to, driving the identification, analysis and validation of cost avoidance and recovery opportunities with the goal of connecting one defect to others that may be related. This will be accomplished by analyzing concepts for recovery opportunities which could be provided by various departments such as Data Mining and Overpayment operations, Health Plans, etc., independent data mining and researching all resources that support the identified concept. The incumbent would audit and analyze healthcare claim data and provides solutions to prevent, recover, correct, and implement solutions to complex Medicaid claims payment issues.

Responsible for serving as an expert in data analysis, reporting and formulating recommendations and providing guidance to other data analysts. As a successful individual on this team, you will work with key business partners as subject matter expert to accomplish assigned goals which may include but not limited to:

Preferred locations - Indianapolis, IN, Atlanta, GA, Richmond/Virginia Beach, VA, Mason, OH, or Chicago, IL

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.
Qualifications
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.
Preferred Qualifirations:
Generate leads which contribute to overpayment recovery and/ or cost avoidance. Provide direction to data team for building queries to analyze complex data sets and identify Medicaid prepayment edits as well as overpayment trends and patterns. Has both technical and operational expertise. Lead meetings and initiatives on very complex concepts with senior level executives and drive said projects to completion with minimal oversight. Develops and executes complex data analysis and reporting. Creates and develops partnerships with other departments including Health Plans, Claims, and Regulatory. Successful individuals will benefit from a solid understanding of Anthems existing systems (Macess and FACETS, in particular), data warehouses, healthcare claims data analysis, and demonstrated experience and knowledge of healthcare insurance information (health claims data, procedure codes, diagnosis codes, physician specialty codes, etc
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 Worlds Most Admired Companies among health insurers by Fortune magazine, and a 2020 Americas Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. 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.

 
Awards & Accolades for MyTechLogy
Winner of
REDHERRING
Top 100 Asia
Finalist at SiTF Awards 2014 under the category Best Social & Community Product
Finalist at HR Vendor of the Year 2015 Awards under the category Best Learning Management System
Finalist at HR Vendor of the Year 2015 Awards under the category Best Talent Management Software
Hidden Image Url