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Reporting & Data Analysis
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PS32364 Requisition #

Healthcare Economics Consultant

  

Position will support restated financial analytics and reporting to identify drivers and mitigation strategies across outpatient categories. Provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues. Works on large scale initiatives with high dollar cost savings opportunities. Partners with provider contractors to develop contracting strategy and supports all aspects of the contract negotiation process. Can work with multiple provider types, e.g. physician, ancillary, medical groups, or hospitals. Supports a full range of contract arrangements and pricing mechanisms. Works on complex enterprise-wide initiatives and acts as project lead.

 

 

 

Primary duties may include, but are not limited to:

 

  • Uses analytic tools to track both health risks and compliance, as well as supporting the contract negotiation process.

  • Types of analyses include performing sophisticated retrospective data analytics; building new and modifying existing complex models to create predictive impact decision making tools; performing healthcare cost analysis to identify strategies to control costs; projecting cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis; preparing pre-negotiation analysis to support development of defensible pricing strategies; performing modeling to compare various contract scenarios based on member utilization patterns and 'what if' logic; measuring and evaluating the cost impact of various negotiation; researching the financial profitability/stability and competitive environment of providers to determine impact of proposed rates; and projects different cost of savings targets based upon various analytics. Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures.

  • Recommends policy changes and claim's system changes to pursue cost savings.

  • Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable.

  • Recommends standardized practices to optimize cost of care. Educates provider contractors on contracting analytics from a financial impact perspective.

  • May recommend alternative contract language and may go on-site to provider premises during contract negotiations.

  • Participates on project team involved with enterprise wide initiatives. Acts as a source of direction, training and guidance for less experienced staff.

Qualifications:

  • Requires BS/BA degree in Mathematics, Statistics, or related field; minimum of 5 years’ experience in broad-based analytical, managed care payer or provider environment; considerable experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background.

  • Master's degree preferred.

  • Familiarity with relational databases such as SAS or SQL required

  • Healthcare experience strongly preferred

  • Must be able to sit onsite in an Anthem office: Indianapolis, Mason, Atlanta, or Virginia Beach. 

AnEqualOpportunityEmployer/Disability/Veteran

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Phyllis Webster referred the Provider Network Mgr I - PS31667 position. Jan 15, 2020
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Be Part of an Inclusive Culture

Workforce Diversity

At Anthem Inc., we believe that having a diverse workforce is critical to innovation and to addressing the needs of the diverse customers and communities we serve. Women make up 76% of our workforce and 63% of all management roles. People of color represent 43% of our workforce and 29% of management. More about the breakout of our workforce in Anthem Corporate Responsibility.

Workforce Recruitment

Our commitment to improving access to affordable care while simplifying the health care experience for consumers requires the best talent, passion, broad insight and experience, and an innovative mindset.

We partner with external organizations, colleges and universities, and our nine associate resource groups to recruit, retain, and develop a workforce that reflects the communities we serve -- and to implement best practices to offer an inclusive environment for all. Our partnerships include: UNCF, United States Business Leadership Network (USBLN); National Association on Disability (NOD), Amerigroup National Advisory Board; Easter Seals; Job Accommodation Network (JAN); MindShift; VeteranRecruiting; HirePurpose; Hiring Our Heroes; Military Spouse Corporate Career Network; Out & Equal; Hispanic Association on Corporate Responsibility (HACR); Diversity Best Practices, among many others.

Associate Resource Groups

Our nine Associate Resource Groups (ARGs) include associates from all areas of the organization, multiple locations and a wide-range of experiences and backgrounds. The groups encourage diversity of perspectives and insight and help put the passion of our associates into action in order to make a real difference for our consumers and the communities we serve. Our ARGs help tackle business issues, participate in community programs, and facilitate opportunities for education, development, and networking. ARGs are open to all Anthem associates.

  • ABLE: Disability Inclusion Network
  • ACE Asians Committed to Excellence
  • APEX African American Professional Exchange
  • HYPE Healthcare Your Professional Exchange
  • PRIDE Promoting Respect, Individuality, Diversity and Equality
  • SOMOS Hispanic ARG
  • VOA Veterans of Anthem
  • W@VE Working @ Anthem in a Virtual Environment
  • WIN Women’s Inspired Network

LGBTQ inclusion – SAFE Space and Gender Transition Guidelines

We are proud to be recognized by the HRC among the Best Places to Work for LGBTQ Equality by obtaining a perfect score in the Corporate Equality Index. Our PRIDE ARG helps us identify and implement best practices and programs such as the Anthem Safe Space Program, the Gender Inclusion and Transition Guidelines, and Transgender Training for customer-facing associates. This ARG also helped create “Building an LGBT –Friendly Practice”, an online training module that we offer to all health care providers.

People with Disabilities

We have a strong commitment to the employment of people with disabilities and partner closely with external organizations and our ABLE ARG to nurture a culture and a physical environment that are both inclusive of associates as well as customers with disabilities. We have received the Leading Disability Employer Seal by NOD (2016-2017), a perfect score in the USBLN’s Disability Equality Index since 2016 and the Portlight “Getting It Right” Award in 2017 for our work in disaster preparedness and recovery for people with disabilities.

Veterans

It's important to us to offer our veterans opportunities to take their career in a new direction because we believe their spirit of service is essential to improving health care. Our VOA ARG partners with Talent Acquisition to maximize our ability to attract and retain veterans and their family members. The group also focuses on supporting our troops by sending care packages during the holidays and participating in events year-round. Learn more in our veterans’ page.

Unconscious Bias training

We train our leaders to make more informed and effective decisions by mitigating unconscious bias. There’s extensive research about the impact of unintended bias in decisions that affect people in the workplace so in 2017 we launched “Decide: The Neuroscience of Breaking Bias,” an eLearning experience that helps leaders identify, label and take action to minimize bias in order to build effective and inclusive teams.

Connect With Our Communities

Our associates are passionate about serving our members and giving back to the community and the company supports these efforts through several programs.

Year-round, Anthem associates give generously to health-related nonprofit organizations across the country through our Associate Giving Program, which offers a 50 percent match from the Anthem Foundation.

The Dollars for Doers program encourages year-round associate volunteerism—and helps associates’ commitment go even further by providing grants to eligible organizations where the volunteer service is completed. In 2017, our associates logged over 55,000 hours! To make it even easier to volunteer, associates can have up to eight hours of paid volunteer time off each year to be used to volunteer at qualified charities of their choice.

The Volunteer Recognition Program invites Anthem associates to share their volunteer stories or nominate their colleagues who volunteer in the community. Each quarter associates nominate and vote for a winner who exemplifies our value of Caring for Our Communities. The winner chooses an eligible charity to receive a special grant from the Anthem Foundation.

Learn more about how Anthem associates give back to their communities.

 
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