Health Information Manager (Risk Scores)

Description SHIFT: Day JobSCHEDULE: Full-timeYour 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 benefits companies and a Fortune Top 50 Company. Healthcare Information Manager (Risk Scores) The preferred locations for this position are Cerritos, CA, Nashville, TN, Indianapolis, IN and Atlanta, GA but other locations will be considered. The Heath Information Manager (Risk Scores) is responsible for identifying opportunities to deliver affordable quality care to members through analysis of data and transforming business intelligence into action plans. Provides strategic recommendations for improving health care affordability to executives and professional clients. Primary duties may include, but are not limited to:

• Collaborates with the data warehouse analysts in establishing business rules and monitoring adherence.
• Translates data trends into strategic recommendations for program development and action plans.
• Organizes and manages the staffing and work flow on major projects.
• Provides business expertise regarding the appropriate use of data elements and cooperates with reporting personnel from other areas to establish and maintain these common business rules.
• Develops and communicates action plans and assists in planning initiatives to address areas for improvement identified through data analysis and business expertise.
• Collaborates with business user to define media, frequency and audience for distribution of information.
• Evaluates and triages potential projects and studies based on the value, cost benefit analysis and the urgency of the request.
• Manages projects through coordination and negotiation with internal and external clients in a highly matrixed environment.
• Performs strategic data analysis and research to support business needs.
• Develops detailed understanding of relevant business processes, goals and strategy.
• Acts as a source of direction, training and guidance for less experienced staff.
• Makes strategic recommendations to executives.

• Analyzes HCC submissions and other Key Performance Indicators (KPIs) related to MA Risk Scores.
• Works with Finance to determine the financial impact of changes to population risk scores.

• Requires a BS/BA degree.
• 5-7 years' experience in analysis and reporting
• At least 2 years of broad based practical business experience within a business unit; or any combination of education and experience, which would provide an equivalent background.
• Understanding of Medicare risk score and HCC model is required.
• Experience in managed care and data analysis is required.
• Understanding of multiple data sources and formats is required.
• Expert level spreadsheet and database skills is required.
• xcellent knowledge and understanding of standard Business Information tools and programming/query languages.
• Understands and applies Excel functions and macro tools to help solve complex problems.
• Excellent analytical, organizational, planning, and oral and written communication skills required.
• Ability to communicate effectively with multiple levels within the organization.
• Advanced degree in business, science, or health research preferred.
• Providing consultation and making presentations are major parts of this job.
• Influences and negotiates with all levels of management.
• This job focuses on more organizing, more project work, and more focused on developing action plans, and more client knowledge as compared to the Health Information Consultant Senior.