Anthem Inc. Actuarial Jobs

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Anthem, Inc. Staff VP Advanced Analytics - Risk Adjustment in Indianapolis, Indiana


SHIFT: Day Job

SCHEDULE: Full-time

The Staff VP, Risk Adjustment Advanced Analytics will report to the VP & CFO Clinical Solutions, who reports to the Chief Analytics Officer.

The Staff, VP will lead the team focused on Risk Adjustment Analytics as a priority for Anthem’s Commercial and Specialty Business Division focused on Individual and Small Group and Affordable Care Act and the Government Business Division for Medicaid. This position will ensure we have the leadership and strategic approach to drive performance improvement and meet strategic performance objectives for risk adjustment.


Reports to VP & CFO, Clinical Solutions

Team: A Director Risk Adjustment Analytics with five direct reports and nine individual contributor Advanced Analytics Consultants KEY RESPONSIBILITIES

Responsible for top down risk adjustment analytics strategy with oversight across multiple lines of business over the following technical and consulting capabilities with the chief goal of ensuring complete and accurate coding.

Technical Capabilities:

  • Design, build, and execution of automated data systems to support risk adjustment targeting strategies, performance evaluation, and continuous improvement; - Design, build, and execution of on-demand analytic processes to support risk adjustment related business requirements and deliverables such as medical record review, call campaign, and audit support; - Design, build, and execution of risk adjustment related dashboarding capability to support cross-functional visibility into core KPIs to drive programmatic strategy and facilitate strategic insights for and from a broad spectrum of internal risk adjustment stake holders.

    Consulting Capabilities:

  • Oversight of subject matter experts providing consultation to internal risk adjustment business partners in support of targeting strategies and process improvement (both existing and new); - Identification of, and participation in, initiatives to collaborate with internal teams having overlapping goals and/or processes – such as encounters, quality, actuarial, and clinical data acquisition teams; - Support of program valuation efforts. - Partner with internal analytics experts including AI and actuarial teams to facilitate effective integration of Anthem’s broad analytics capabilities in the risk adjustment space. - Collaborate with IT partners to facilitate accurate and timely execution of IT owned ETLs supporting data visualization, inbound and outbound file processing and tracking, and claims extraction. - Stay abreast of regulatory changes in the risk revenue process and collaborate with business owners to align processes and strategies accordingly. - Maintain a professional awareness of industry best practices in support of continuous improvement. - Promote the importance of advanced analytics and leverage analytical insights to enhance business results. - Hire, train, coach, counsel, and evaluate performance of direct reports.



  • BA/BS degree in a quantitative major - 8 years of experience in leading advanced analytical function in a major industry such as healthcare, banking/credit, insurance, e-commerce or consulting; or any combination of education or experience, which would provide an equivalent background - Master’s degree in a quantitative field, MBA or MPH preferred - Effective influencer with strong ability to manage across multiple stakeholders and prioritize effectively - Management experience fostering successful collaboration across internal and external team members - Ability to assimilate disparate information into a cohesive, executive level story - Strong communication, organizational, collaboration skills; executive presence - Proficient in managing across diverse teams, with proven ability to diffuse conflicts and foster team alignment to a productive path

    Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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: PS56017