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Description SHIFT: Day JobSCHEDULE: Full-timeBe part of an extraordinary team Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies, 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. Build the Possibilities. Make an extraordinary impact. Have you worked in a team-based environment to consistently solve complex, medical cost-related problems using large healthcare data sets? Are you searching for a career opportunity to apply your healthcare analytics expertise to develop cost containment solutions for some of the nation’s largest health insurance companies? The AIM Analytics group has an exciting opportunity to help you cultivate a career in medical finance analytics. AIM Specialty Health provides utilization management services, and we’re seeking a self-starting individual who can effectively utilize a combination of critical thinking and analytics skills to demonstrate the financial value of new services and capabilities. How you will make an impact: Establish actuarially-sound cost modeling and forecasting methodologies that accurately assess future business performance across new go-to-market solutions and capabilities.
Obtain, verify, analyze, and model financial target outcomes such as return-on-investment (ROI) and payback periods using claims and authorization data.
Lead and/or actively participate in new solution strategy sessions with AIM medical directors and Solution Design consultants.
Partner with Actuarial team members to validate cost model outcomes, savings modeling assumptions, and ROI recommendations.
Identify medical cost, service utilization, service intensity, unit cost, and membership trends to identify new opportunities for product expansion.
Understand cost levers of AIM services and make recommendations on program design.
Accountable for developing a measurement system to assess financial performance of new solutions following implementation.
Ensure that cost and saving model assumptions are tracking with actual solution performance.
Structure and perform independent analyses and package findings for executive level stakeholders.
Conduct exploratory research on medical finance and cost-of-care outcomes by publishing key cost trends and benchmarks.
Serve as a subject matter expert in trend decomposition to inform the business of key financial risks that require more proactive surveillance.
Use R, SQL, Excel, PowerPoint, and other tools to transform data into insights and report findings to internal and external business partners.
Qualifications Minimum Requirements: BS/BA degree in Mathematics, Statistics, Finance, Computer Science or a quantitative-related field; minimum of 3-5 years related experience in an analytics environment performing medical economics reporting, price setting, evaluation of financial risks and trend projections; or any combination of education and experience, which would provide an equivalent background. Experience specific to health insurance or health insurance claims data or graduate level related education may also be used to offset years of experience.
Advanced SQL experience required
Preferred Skills, Capabilities and Experiences:
Familiarity with medical management or population health programs is highly desired.
Possess working knowledge of healthcare data and measurement standards such as ICD10, CPT/HCPCS, MS-DRG, DxCG, PMPM, and utilization per 1,000.
Advanced Excel skills strongly preferred.
Base statistical skills to analyze, display, describe and summarize data into actionable insights.
Data visualization experience in QlikSense, Business Objects, Tableau, or other BI tools is a plus.
Excellent organizational, analysis planning, and communication skills is critical.
Ability to participate collaboratively on teams producing complex analyses.
Healthcare Analytics consulting experience highly desired.
Excellent analytical and critical thinking skills.
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: PS72839-Georgia
Vacancy expired!