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Practice Consultant - Evansville, IN location preferred (PS25235)Location: Indiana, United StatesNewRequisition #: PS25235Your 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.Practice Consultant - Evansville, IN location preferred (PS25235)Even though this position is considered remote, the individual is preferred to live in or near the Evansville, IN area due to days required to come into the office.Summary: The Practice Consultant is responsible for providing support to providers to improve the effectiveness and efficiencies of provider practices.This individual is dedicated to and responsible for working in the field with PMP and OB providers to improve HEDIS scores and implement best practices. Obtains and analyzes quality metrics and reports for care opportunities, supports practice implementation of care coordination and care management, identifies action plans for providers to implement to improve quality, cost and the patient experience and participates in design, development, and implementation of community learning forums. This individual will also be responsible for developing and executing a regional business plan and evaluation annually; monthly collaboration meetings with providers and external stakeholders, such as County Health Dept, Rural Health Assoc as well as advanced analysis to ID trends, barriers and drive interventions & lead the Essentials and OBQIP programs.Primary duties may include, but are not limited to:
Assesses current practice patterns, assets and challenges utilizing NCQA Standards, HEDIS audits, site reviews and medical records reviews.
In partnership with the PMP, evaluates results of the initial assessment and establishes a project plan with the practice that establishes goals and objectives for improvement.
Provides ongoing practice support and sustains the partnership.
Establishes regular meetings to track progress.
Obtains and analyzes quality metrics and reports for care opportunities, supports practice implementation of care coordination and care management, identifies action plans for providers to implement to improve cost, quality and the patient experience and participates in design, development, and implementation of community learning forums.
Collaborates with Patient Centered Primary Care team including but not limited to: engagement manager, clinical liaison, provider contractors and network relations reps to meet provider and practice service needs.
Actively participates in developing program recommendations and action plans (Internal).
Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients.
Promotes practice transformation to team based patient centered care delivery.
Provides education for practices to develop expertise with metrics and data review for quality improvement.
May participate in various community and multi-department committees to assure effective program implementation.
Tracks progress of program and prepares status reports to management or senior management.
Maintains up to date knowledge on Patient Centered medical Home, Care Delivery System Redesign and Accountable Care Organizations.
Improves the understanding and sensitivity to the unique needs of this population and the care givers.
Qualifications:
Requires an AS/BS in nursing; minimum 5 years of managed care experience; minimum 2 years of clinical experience.
Minimum 2 years of professional presentations to small and large audiences; or any combination of education and experience, which would provide an equivalent background required.
Current, unrestricted clinical license appropriate to field of specialty (LVN/LPN, RN, NP, PA, LCSW, LSW, etc.) as required.
BSN or MSN preferred or any combination of education and experience, which would provide an equivalent background.
Travel required (approx. 70% locally).
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc 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.
