Description
SHIFT: Day Job
SCHEDULE: Full-time
Be 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?
Prov Contract/CofC Analyst
Job Descriptions: Provides analytic support to higher level Analysts and Consultants in helping them run their programs and/or to support the contracting process. Primary duties may include, but are not limited to:
Modifies existing analytical models to create predictive impact decision making tools and may build new models with assistance from higher level Analysts and Consultants as needed.
Work closely with contracting team to build/ maintain/ update fee schedule related to our provider contracts.
Performs varied data analyses which may include: post implementation analyses; retrospective data analyses; analyses to track both health risks and compliance which are critical means of managing long-term health costs; analyses to identify cost increases in medical services; analyses of practice patterns in relation to office visits, referral practices, and specialty care procedures to help identify strategies to control costs; pre-negotiation analysis to support development of defensible pricing strategies; and the measurement of the cost impact of various negotiation proposals to better forecast how pricing changes could affect the company's bottom line
Prov Contract/CofC Analyst Sr
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. Typically works with one provider type, e.g. physician, ancillary, or medical group. Provides advice and analytic support to contract negotiators and management on cost of care issues to help reduce costs without compromising quality of care. Primary duties may include, but are not limited to:
Work closely with contracting team to build/ maintain/ update fee schedule related to our provider contracts.
Performs varied data analyses which may include: developing moderately complex ROI models and performs healthcare cost analysis to identify strategies to control costs; preparing pre-negotiation analyses 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 proposals; researching the financial profitability/stability and competitive environment of providers to determine impact of proposed rates; and projecting 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 and 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.
Qualifications
Prov Contract/CofC Analyst
Job Qualifications:
Requires BS/BA degree in Mathematics, Statistics, or related field and minimum of 2 years' experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical analysis and healthcare modeling; or any combination of education and experience which would provide an equivalent background.
Master's degree preferred.
High level mastery of Excel required
Minimum of 2 years' experience with SQL coding preferred
SAS, Teradata experience preferred
Prov Contract/CofC Analyst Sr
Requires BS/BA degree in Mathematics, Statistics, or related field and a minimum of 3 years' experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical analysis and healthcare modeling; or any combination of education and experience which would provide an equivalent background.
Master's degree preferred.
High level mastery of Excel required
Minimum of 2 years' experience with SQL coding preferred
SAS, Teradata experience 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.
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: PS71636
