Prov Contract/CofC Analyst or Analyst Sr- Job Family
Company: Anthem, Inc
Location: Fort Worth
Posted on: June 25, 2022
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Job Description:
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.
+ 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.
+ May map disparate sources of data to a common language for
analysis. May work on projects as assigned.
Prov Contract/CofC Analyst Sr
Job Descriptions:
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 Medical Directors, 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:
+ Performs varied data analyses which may include: developing
moderately complex ROI models and performs 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 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 2-4 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.
Preferred Technical Skills:
+ SQL experience required.
+ SAS and Python experience preferred.
Prov Contract/CofC Analyst Sr
Job Qualifications:
+ Requires BS/BA degree in Mathematics, Statistics, or related
field and a minimum of 3-5 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.
Preferred Technical Skills:
+ SQL experience required.
+ SAS and Python 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: PS71771-US
Keywords: Anthem, Inc, Fort Worth , Prov Contract/CofC Analyst or Analyst Sr- Job Family, Professions , Fort Worth, Texas
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