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Anthem, Inc. Advanced Analytics Senior/Consultant-Risk Adjustment in Norfolk, Virginia


SHIFT: Day Job

SCHEDULE: Full-time

Advanced Analytics Analyst Senior or Advanced Analytics Consultant-Risk Adjustment

(hiring level based on experience).

The preferred locations for this position are

Atlanta, GA, Virginia Beach, VA and Mason, OH and Indianapolis, IN

The Advanced Analytics Analyst Senior-Risk Adjustment creates statistical models to predict, classify, quantify, and/or forecast business metrics. Designs modeling studies to address specific business issues determined by consultation with business partners. Primary duties may include, but are not limited to:

  • Prepares analytical data sets in support of modeling studies

  • Builds, tests, and validates statistical models.

  • Publishes results and address constraints/limitations with high-level business partners.

  • Proactively collaborates with business partners to determine identified population segments and develop actionable plans to enable the identification of patterns related to quality, use, cost and other variables.

The Advanced Analytics Consultant-Risk Adjustment employs advanced analytics 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. Consults 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 measure program outcome and demonstrate value, to help win and retain clients, and to support information based strategic decision making.

Primary duties may include, but are not limited to:

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

  • Develops and refines analysis templates for problem diagnosis and opportunities assessment.

  • Consults on all considerations related to designing and executing tests or pilot programs.

  • Contributes to the design of new program/initiative based on test/pilot outcomes.

  • Develops targeting criteria or customer segmentation based on analytical insights, clinical inputs, and product design and operations considerations.

  • Develops predictive models and other tools that help target the right members.

  • Develops methodology to measure clinical, utilization and financial outcomes of a program/initiative.

  • Conducts in-depth research to address challenging issues in measuring outcomes.

  • Leads applied research projects; authors white papers, presents at industry conferences and submits journal publications.

  • Addresses limitation of certain data sources and evaluates incremental value of new data sources.


Advanced Analytics Analyst Senior-Risk Adjustment

Job Code: 670149

Job Level: E13

AIP: 10%-12.5%

Salary Range: Minimum $82,000– MRP $102,500 (National Zone)

  • Requires Graduate-level degree with concentration in a quantitative discipline such as statistics, computer science, cognitive science, economics, or operations research

  • 3-5 years direct experience programming large, multi-source datasets with SAS required.

  • 3-5 years in health care setting; or any combination of education and experience, which would provide an equivalent background. PhD preferred.

  • Intermediate to Advanced expertise with software such as SAS Stat, SAS ETS, SAS Enterprise Miner or equivalents.

  • Experience with Teradata, SQL, SQL Server, or equivalent.

  • Proven ability to design modeling studies.

  • Experience with data models, addressing data quality issues in study design, constructing robust and efficient analytical data sets.

  • Significant experience in healthcare related field strongly preferred.

  • Proven ability to present meaningful results to a business audience.

  • Ability to participate collaboratively in a team tasked to produce complex analyses on a rigorous schedule.

  • Strong written and verbal communications skills and the ability to present to large multi-disciplinary audiences on a regular basis.

Advanced Analytics Consultant-Risk Adjustment

Job Code: 670157

Job Level: E14

AIP: 12.5%-17.5%

Salary Range: Minimum $99,360 – MRP $124,200 (National Zone)

  • Requires Graduate-level degree with concentration in a quantitative discipline such as Mathematics, Statistics, Economics, Epidemiology, Engineering, Computer Science or Operations Research

  • 5-10 years’ experience in related health care analytics; or any combination of education and experience, which would provide an equivalent background. PhD preferred.

  • 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, database/direct marketing, online retails, consulting, etc.

  • Substantial analytical experience in healthcare industry preferred.

  • Advanced expertise with SAS or equivalents analytical tools comprehensive experience with Teradata, SQL, or equivalent data base tools.

Department Specific Requirements for all levels

  • Understanding of risk scoring models (HHS-HCC, CDPS, CMS-HCC)

  • Knowledge of risk adjustment in healthcare

  • Experience with healthcare data (Claims, Eligibility, ICD-10)

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran

REQNUMBER: PS38775-Virginia%20Beach