Health Information Consult Sr
DescriptionSHIFT: Day Job
Your Talent. Our Vision. At CareMore, a proud member of the Anthem, Inc. family of companies, 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.
CareMore is a proven care delivery model for the highest-risk. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. We build and lead integrated, multi-disciplinary clinical teams to care for the most complex patients. We strive for excellence and have achieved significant and measurable improvement in total cost of care, clinical outcomes, and experience. As an Anthem subsidiary, we benefit from the scale and resources one of America’s largest managed healthcare organizations.
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.
Location: 100% Remote M-F 8:00am-5:00pm (flexible)
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 information/project 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 BS/BA 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 strongly preferred.
- Excellent oral and written communication, analytical and planning skills and knowledge of standard Business Information tools and programming/query languages preferred.
- Experience in managed care and data analysis is preferred.
- Practical business experience is preferred.
- Experience with STARS & Quality programs highly preferred
- Experience with evaluation of clinical interventions/or programs highly preferred
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 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.
Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.