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Director

Company: Anthem, Inc
Location: Hialeah
Posted on: May 3, 2021

Job Description:

Description

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 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 benefits companies and a Fortune Top 50 Company.

Title: Business Info Developer Director supporting Aspire

Preferred Location(s): Indiana, Ohio, Virginia, Florida, Georgia, Texas (will consider other locations)

Status: Work at Home, Full-time, Salary, Bonus Potential

The Business Info Developer Director is responsible for developing and executing more complex business information analyses at an expert level.

Primary duties may include, but are not limited to:

+ Applies broad knowledge, experience, and insight to make smart decisions and recommendations. Cultivates positive professional & interpersonal relationships with various stakeholders.

+ Effectively uses coaching, influencing, negotiation, and persuasion in interpersonal interactions. Understands complex problems quickly, proposes solutions, and provides clear direction.

+ Undertakes complex assignments and projects requiring additional specialized technical knowledge including data warehouse structures and application of database query tools.

+ Develops very complex and varied strategic report applications and analyses from a Data Warehouse. Establishes and communicates common goals and direction for team.

+ Establishes and maintains advanced knowledge of data warehouse database design, data definitions, system capabilities, and data integrity issues. Acts as a source of direction, training and guidance for less experienced staff.

+ Must be able to recognize when a strategic change in process is required and direct resources effectively and efficiently to achieve the desired business results.

+ Monitors project schedules and costs for own and other projects.

+ Develops and supports very complex Data Warehouse-related applications and analyses for business areas requiring design and implementation of database tables.

+ Designs and manages studies as requested by internal and external (e.g., Network Management, Health Solutions, Finance, NCQA, HEDIS) clients for purposes of ensuring accreditation, improving health, and analyzing business opportunities and areas for improvement.

+ Assures quality and integrity of data collected, analysis performed, and reports generated. Develops methods for improving internal techniques and processes.

+ Utilizes multiple data systems to accomplish objectives.

Additional information in regards to the position specifics for supporting Aspire:

+ Act as central command / nerve center with respect to referral allocation for all Lines of Business including matching Referral Supply and Market Demand, understanding contractual requirements, business rules and operational standards

+ Oversee end-to-end data flow for eligibility and referrals and identify ways to streamline/create efficiencies

+ Track inbound referrals from health plans in partnership with IT team

+ Work with clinical leadership and field analysts on capacity planning based on inbound volumes

+ Process accurate and timely cascade of referrals into the EMR

+ Partner with field analysts on turning referrals on/off in the EMR based on team capacity

+ Ensure timely execution of eligibility changes; solution for automate eligibility checks

+ Lead planning for new programs and market launches

+ Ensure new programs are appropriately planned for and executed

+ Ongoing Operations Support-

+ Translate census/eligibility data for billing purposes

+ Reporting

+ Develop / maintain weekly ops meeting reporting

+ Support ad-hoc hoc health plan needs like territory checks, expansion related analyses and supported the flow from Data Science team to IT for opportunity analyses & EOL/ROI analyses.

Qualifications

+ BS/BA degree;

+ 8-10 years' experience

+ Any combination of education and experience, which would provide an equivalent background. Experience in managed care and data analysis required.

+ Understanding of multiple data sources and formats required.

+ Excellent knowledge and understanding of data warehouse structures, data flows and standard Business Information tools and programming/query languages is also required.

+ Excellent leadership, problem solving, organizational, planning, presentation and interpersonal skills. Advanced degree in business, science, or health research is preferred.

+ Ability to communicate effectively with all levels in the organization including executives.

+ This job spends time thinking about programming and is much more focused on designing solutions as compared to the Bus Info Developer Consultant Sr.

+ This job functions as an independent operator and feels comfortable talking to the Executive Leadership team (ELT).

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 careers.antheminc.com. 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: PS49201-Florida

Keywords: Anthem, Inc, Hialeah , Director, Other , Hialeah, Florida

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