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Anthem, Inc Pharmacy or PBM Business Info Consultant (Clinical Quality Measures and Healthcare Outcomes experience) - Multiple Locations - PS23377 in New Haven, Connecticut

Pharmacy or PBM Business Info Consultant (Clinical Quality Measures and Healthcare Outcomes experience) - Multiple Locations - PS23377

Location: Atlanta, Georgia, United States

Requisition #: PS23377

Post Date: Jun 19, 2019

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 atone of America's leading health benefits companies and a Fortune Top 50 Company.

The position will work from one of the following Anthem locations:

Atlanta, GA

Chicago, IL

Las Vegas, NV

Louisville, KY

Mason, OH

Minneapolis, MN

Morristown, NJ

St Louis, MO

Virginia Beach, VA

Wallingford, CT

The Business Info Consultant develops insights through clinical data analytics of clinical program performance against health outcomes data and real world evidence. Summarizes and presents activity and outcomes reports to key stakeholders. Improves on pharmacy measure performances through the development, design, and evaluation of clinically appropriate programs that encourage medically appropriate and cost effective health care. Define and create clinical metrics and targeting strategies to improve member outcome in collaboration with product owner. Creates compelling interactive dashboards for internal and external customers to identify, design, recommend and execute solutions to deliver actionable information. Provides statistical oversight on clinical study design and program evaluations, ensuring sound statistical methodologies in study design, sample size estimation, statistical analysis planning, statistical modeling, data handling, analysis and reporting. Uses SQL/SAS, develop clinical reporting packages that incorporates pharmacy, medical, and membership data elements that pertains to improving healthcare quality. Develops provider business intelligence reports in the areas of advanced analytics, forecasting, data extrapolation, and predictive modeling. Implements standard dashboards and delivery mechanisms enabling data-driven insights for internal and external clients. Develops appealing data visualizations leveraging multiple internal and external data sources (quantitative and qualitative), and drawing insightful conclusions for decisions makers. Executes a plan for ongoing evaluation and product monitoring reports for program performance through automated procedures.

Primary duties may include, but are not limited to:

  • Develops and analyzes business performance reports using healthcare data (e.g. claims, provider, and membership) and provides notations of performance deviations and anomalies.

  • Creates and publishes periodic reports, as well as any necessary ad hoc reports.

  • May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

  • May make recommendations based upon data analysis.

  • Requires a BS/BA degree; MA/MS preferred in related field (Computer Science, Statistics, Biostatistics, Public Health, Pharmacoeconomics); 5-10 years data analysis or related experience (SAS/SQL; data visualization; data analysis); or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications

  • SAS Certification in Base Programming, Advanced Programming, Data Scientist, Advanced Analytics Professional.

  • 3 years of experience in data visualization authoring/creation tool (i.e. Tableau, Power BI, Domo, Qlik, Datorama or similar visualization program).

  • Proven skills in articulating and communicating data-driven insights and strategies both verbally and in writing to colleagues and senior leadership.

  • Experience with multiple database platforms (Hadoop, SQL, etc) and knowledge of query tools and statistical software is required.

  • Experience performing complex data aggregation, cleansing and quality audits.

  • Ability to manipulate large sets of data is also required. Able to automate data querying/reporting processes.

  • Strong statistical modeling experience (regression, segmentation, CHAID)

  • Strong analytical, organizational and problem solving skills.

  • Ability to communicate in a succinct and precise manner for management contacts.

  • Ability to communicate in technical detail to development and vendor resources.

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 careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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