Clinical Quality Program Manager PS26626

Clinical Quality Program Manager PS26626

27 Aug 2024
New Hampshire, Manchester 00000 Manchester USA

Clinical Quality Program Manager PS26626

Vacancy expired!

Clinical Quality Program Manager PS26626Location: United StatesNewRequisition #: PS26626Your 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.Clinical Quality Program ManagerLocation: Remote is available. Must reside within 1 hour of an Anthem Office.Responsible for serving as a liaison with LOB leaders and overseeing the HEDIS Medical record review process for a major line of business.Primary duties may include, but are not limited to:Leads LOB level HEDIS strategy and production meetings and determines the appropriate operational focus and course of action to achieve goals.Ensures that appropriate HEDIS processes are in place to support abstraction and research production and quality goals.Works with the clinical intervention team to design studies to identify barriers to medical interventions.Ensures that appropriate reporting is in place and reviews reporting regularly to monitor actual to goal performance measures.Develops performance improvement plans and oversees the clinical quality improvement activities/projects to improve the quality of care for members.Assures compliance with corporate QI work plans.Assures that all QI activities are relevant to the needs of targeted population.Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of data analysis results.Participates in and provides input to the development of new product designs for major line of business.Oversees the implementation of new initiatives.Leads interactions with regulators or oversight entities.Oversees quality improvement activities for the largest, most complex state programs.Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.Current unrestricted license, certification in applicable field (i.e. CPHQ) and/or a MS in the health field (i.e. Nursing) is preferred.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.

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