Anthem HEDIS Business Info Consultant PS8904 in Dearborn, Michigan

HEDIS Business Info Consultant PS8904

Location: United States

Field: Reporting & Data Analysis

Requisition #: PS8904

Post Date: Jun 29, 2018

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and 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.

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 (any combination) of the following: Commercial, Marketplace, Medicare, Medicaid 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. Establishes and maintains excellent knowledge of HEDIS Technical Specifications, EDWard data warehouse database, HEDIS source tables and backend tables and data integrity issues.

Primary duties may include, but are not limited to:

Responsible for performing detailed analysis of eligible populations related to HEDIS reporting, drawing samples and chases for annual HEDIS reporting using certified software. Providing benchmarking analysis for annual and monthly HEDIS rates. 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.

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.

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.

Requires a BS/BA degree in related field; minimum of 5 years of 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.

Good communication skills are required.

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.

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 An Equal Opportunity Employer/Disability/Veteran