Description
SHIFT: Day Job
SCHEDULE: Full-time
Be a Part of an Extraordinary Team!
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Business Analyst II
Location : Remote opportunity-all locations to be considered.
This is an opportunity to join a growing team of associates within DBG (Diversified Business Group). Our team is responsible for identifying claims processing issues on WGS through data mining and then creating business requirements documents (BRD) to assist with creation of algorithms that will contribute to cost of care savings and total program savings. These positions will primarily perform WGS tasks in conjunction with the pre-pay initiative project for Datamining and Overpayments (DMO).
How you will make an Impact;
Analyzes business needs to determine optimal means of meeting those needs.
Assessing overpayment opportunity by reviewing WGS claim samples.
Accessing provider contracts, company claims policies and coding guidelines to support prevention opportunities.
Partners closely with query data analysts to create algorithms that will identify overpayments for prevention.
Develops and maintains collaborative relationships with query developers, business owners and partners as well as DBG consultants and analysts.
Manages and prioritizes own work based on business needs.
Researches leads to identify additional overpayment savings opportunities.
Develops Business Requirement Documentation (BRD) and completes UAT and coordinates PNP (process and procedure) documentation, involving those in and outside the business unit.
Collaborates, provides guidance to team members and serves as a resource for the team.
Identifies process improvement opportunities that result in increased savings.
Qualifications
Minimum Requirements:
Requires a BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Commercial claims experience
Experience with WGS
Advanced skill level with MS Excel (pivot tables, formulas, V-lookup)
Must possess strong analytical and problem-solving skills with research-oriented approach; strong written, verbal and interpersonal communication skills are required
Ability to manage multiple projects in various stages to completion
Demonstrated meeting facilitation skills
Knowledge of systems capabilities and business operations is strongly preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a `sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.
Applicable to Colorado Applicants Only
Annual Salary Range*: $56,080 - $70,100
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.
REQNUMBER: PS71485-Virginia
