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Anthem, Inc. Clinical Programs Director in Cincinnati, Ohio


SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., 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 at one of America's leading health care companies and a Fortune Top 50 Company.

The clinical department of the Anthem health economics division is dedicated to helping individuals to gain greater value from their health plan, their doctors and the health dollars they spend. We blend technology and data analysis to improve the safety, quality and coordination of health care services, helping to lower costs.

Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.

  • Use data-driven approaches to identify opportunities and develop analytic solutions to improve quality of care, health, and contain healthcare cost across the continuum of care, various population segments, and multitude of intervention designs.

  • Employ empirical estimation approaches to gain critical insights into member behavior drivers and preferences, product/program concepts and value propositions, operational effectiveness and efficiencies, client specific health gaps and needs.

  • Consult business leaders and internal partners to apply the insights to test and drive product innovation and enhancement, to target the right members for the right service, to demonstrate value, and to support information based strategic decision making.

    Primary duties may include, but are not limited to:

  • apply behavioral economic principles to the understanding of population health challenges, and the design of effective, economical interventions;

  • quantify economic implications of programs to improve population health status;

  • relate priorities and drivers of corporate divisions of actuarial science and health economics, focusing on aspects pertinent to population health status;

  • provide analytical insights to support business solution development based on quality, use, cost and other key drivers;

  • develop and refine analysis templates for problem diagnosis and opportunities assessment;

  • consult on all considerations related to designing and executing tests or pilot programs;

  • contribute to the design of new program/initiative based on test/pilot outcomes;

  • develop targeting criteria or customer segmentation based on economic insights, clinical inputs, product design and operations considerations;

  • develop methodology to measure financial, clinical and utilization program/initiative performance;

  • conduct in-depth research to address challenging issues in measuring outcomes;

  • lead applied research projects;


Requires degree with concentration in a quantitative discipline such as applied economics (preferred), public health, epidemiology, actuarial science, mathematics, statistics, engineering, computer science or operations research ; 5-10 years’ hands-on experience in related health care analytics; or any combination of education and experience, which would provide an equivalent background. Experience with developing expert modeling system for segmentation/stratification that supports customized strategies for different customer segments in a major industry highly desirable - healthcare, financial, consulting, etc. Substantial analytical experience in healthcare industry preferred. Advanced expertise with R, Python, SQL, or equivalent analytical tools

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. Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.