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Health Information Consult Sr (PS33313)

Company: Anthem, Inc
Location: Cerritos
Posted on: March 25, 2020

Job Description:

Your Talent. Our Vision. At CareMore , a proud member of the Anthem, Inc. family of companies specializing in providing patients a complete and pro-active health care experience, it's a powerful combination. It's 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 Work consultatively with Clinical Operations, Utilization Management, Quality Management, Case Management, Performance Management and Risk Adjustment teams to devise, analyze, and enhance pro forma models, reports, and analysis, including Star Dashboards, Pharmacy expense and utilization, Specialty, PCP and ancillary utilization and cost trend and pattern analysis, clinicclinician productivity, Physician incentive program, Acute and SNF inpatient utilization (MS DRG Case Mix Index analysis, days and admits per thousand, ALOS, readmit calculations, etc.), HCC Risk Adjustment, HEDIS, EMREPM, Predictive Modeling for patient identification and intervention. Apply statistical concepts such as standard deviation, geometric mean, quartilesdeciles stratification of cost vs. acuity, bell curvesoutlier evaluation, correlation coefficients, population size credibility, predictive R2, etc. Bring analytic insights alive via creative, intuitive visualizations. Responsible for identifying opportunities to improve health care affordability through analysis of data and transforming business intelligence into action plans. Provides strategic recommendations for improving health care affordability to executives and professional clients. Primary duties may include, but are not limited to Collaborates with the data warehouse analysts in establishing business rules and monitoring adherence. Provides business expertise regarding the appropriate use of data elements and cooperates with reporting personnel from other areas to establish and maintain these common business rules. Translates data trends into strategic recommendations for program development and action plans. Tracks and prioritizes projects through coordination and negotiation with internal and external clients to improve the efficiency of informationproject plan generation. Evaluates and triages potential projects and studies based on the value, cost benefit analysis and the urgency of the request. Performs strategic data analysis (data mining) and research as appropriate to support business needs (e.g., disease management, provider profiling, etc.). Develops detailed understanding of relevant business processes, goals and strategy in order to provide analysis and interpretation. Develops and communicates action plans to address areas for improvement identified through data analysis and business expertise. Assists in planning initiatives to address areas for improvement. Collaborates with business user to define media, frequency and audience for distribution of information. Mentors (formally and informally) less experienced associates and identifies training needs and initiates education to address skill and knowledge gaps. Requires a BSBA degree at least five years related experience in analysis and reporting or any combination of education and experience, which would provide an equivalent background. Excellent knowledge and understanding of data warehouse data structures and data flows is required. Excellent oral and written communication, analytical and planning skills required. Knowledge of standard Business Information tools and programmingquery languages preferred. Experience in managed care and data analysis is preferred. Practical business experience is preferred. This job focuses more on higher level customers and developing action plans as compared to the Health Information Consultant job. AnEqualOpportunityEmployerDisabilityVeteran 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 EmployerDisabilityVeteran

Keywords: Anthem, Inc, Cerritos , Health Information Consult Sr (PS33313), Healthcare , Cerritos, California

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