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Anthem, Inc. Clinical Quality Compliance Administrator - FHPS in Cincinnati, Ohio


SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

National Government Services is a proud member of Anthem's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.

Location: This position is eligible to work remotely.

East Coast or Central Time preferred.

How you will make an Impact:

The Clinical Quality/Compliance Admin for FHPS will be responsible for coordinating Quality Management (QM) activities related to compliance and accreditation for an assigned SBU.

Primary duties may include but are not limited to:

  • Develops and maintains pertinent compliance plans.

  • Monitors adherence to plans and prepares status reports.

  • Conducts audits, identifies training and communication needs, and implements related programs.

  • Ensures all policies and procedures are updated as legislation or accreditation standards change.

  • Implements standardization of procedures and documentation within SBU.

  • Develops and delivers executive level presentations and represents senior management on compliance issues and related committees.


Minimum Qualifications:

  • Requires a BA/BS and a minimum of 3 years compliance, audit or quality improvement experience; or any combination of education and experience which would provide an equivalent background.

  • Ability to travel overnight may be required.

Preferred Skills, Capabilities, and Experiences:

  • Experience with regulatory/accreditation audits and knowledge of regulatory/accreditation standards in a health or managed care environment is preferred.

  • RN preferred.

  • Utilization management experience is preferred.

  • Knowledge of NCOA preferred.

  • Experience within FHPS preferred.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.