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Manager Clinical Quality - Any Anthem Location - PS29210Location: United StatesNewRequisition #: PS29210Your 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.Location: Must work from an Anthem location. This is not a work from home opportunity.The Manager Clinical Quality is responsible for managing the day-to-day activities of one or more clinical quality program components related to HEDIS & STARS reporting and medical record collection.Primary duties may include, but are not limited to:
Implements and evaluates current processes including operational statistics, service standards and process improvement initiatives.
Provides oversight in the planning, implementation and coordination of process related to pursuit, research and abstraction Medical Records
Participates in internal and external quality review activities.
Manages and oversees quality assurance activities, which may include, but is not limited to: managing the production, analysis, and submission of the annual HEDIS report; coordinating audit activities with other regions.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires a BS
3 years of managed care experience, including experience in HEDIS operations, development and knowledge of the quality process and QI techniques;
2 years of supervisory experience; or any combination of education and experience, which would provide an equivalent background.
Experience with Medicare, Medicaid and Commercial.
Present and run reports in a consumable format.
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.
