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Anthem, Inc. Provider Credentialing Data Analyst in Visalia, California


SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination. It’s 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.

For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Work Hours: Monday – Friday; 8:00 am – 5:00 pm

Location: Can be REMOTE: CA, TN, VA, MA, and NY

The Provider Credentialing Data Analyst is responsible analyzes, researches, coordinates and reports on provider file data to support both internal and/or external request. To succeed in this role, candidate needs to be analytical and resourceful, an excellent communicator who’s able to explain raw data for credentialing and re-credentialing team.

What does a typical day look like?

Primary duties may include, but are not limited to:

  • Generates provider data reports and analyses to support internal client needs including network management, sales, account management, and other key functions.

  • Performs provider data analysis and reporting in response to external request from providers and/or regulatory agencies.

  • Serves as a technical data expert and liaison between the provider database organization, and other functional areas to support data requests and ensure uniform and consistent data and data flow.

  • Acts as a liaison with the assigned analyst completing the report and the requesting department and/or provider, clarifies report to ensure that it meets the client’s needs and helps to clarify additional required information or data needs.

  • Ensures the quality and accuracy of all reports. Perform provider data support, data/file analysis, network analysis, surveys, reporting (including creating and publishing), and other ad hoc data requests.

  • Uses GeoNetworks and other software tools.

  • May be responsible for enhancements and testing.


What You Contribute:

  • Requires a BA/BS degree in a related field;

  • 3-5 year of data file/reporting experience, and experience using analytics and/or relational databases; or any combination of education and experience, which would provide an equivalent background.

  • Experience using software such as GeoNetworks preferred.

  • Must have Excel knowledge

  • Advanced in SQL, analysis tools (e.g. SAS), NCQA and HEDIS

  • Excellent analytical and communication skills

  • Outstanding organizational and problem-solving aptitude

  • Knowledge of credentialing and re-credentialing preferred

What We Have to Offer:

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.

REQNUMBER: PS48001-California