Anthem Investigative Analyst - US - #130884 in Roanoke, Virginia

/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 willdrive 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.

Preferred Location: Virginia Beach, VA

Other Locations Considered: US

_Investigative Analyst_ Responsible for working with investigators, clinicians in HQA and the MBUs to data mining tools to determine if patterns of abusive practices or fraudulent activities are occurring within the company. Primary duties may include, but are not limited to: * Develop possible scenarios and impacts from trends and patterns noted and perform further research. * Determine the potential financial impact of adverse trends and work with clinicians to determine possible quality of care issues that need to be investigated. * Include scenarios to detect member and provider fraud schemes.


Investigative Analyst * Requires a BA/BS degree, 1-3 years related experience in statistics, actuarial analysis or medical profiling; or any combination of education and experience, which would provide an equivalent background. * SQL developer experience required and knowledge of query tools /Preferred Experience beyond requirements/ * Expert level in Excel and Access * The ability to use SQL Developer Tools (2012 or higher); e.g., Visual Studio Code, Server Data Tools, Server Mgmt. Studio, Server BI * SAS developer, Teradata analytics, Microsoft DOT NET and/or JavaScript experience highly desirable * Experience with relational databases * Experience with EdWard /Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran./ /__/

Job Fraud

Title: Investigative Analyst - US - #130884

Location: VA-Roanoke

Requisition ID: 130884