Anthem QI Specialist - Hanover, MD - PS22258 in Columbia, Virginia
QI Specialist - Hanover, MD - PS22258
Location: United States
Requisition #: PS22258
Post Date: Jun 11, 2019
Your 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: This is an office based position in the Hanover, MD health plan office.
The QI Specialist is responsible for performing and/or documenting quality reviews bases on departmental procedures and contributes to standardizing the quality review approach to be in compliance of contractual, State, and Federal requirements.
Primary duties may include, but are not limited to:
-Focuses on identifying, recommending and implementing a standardized approach to performing and scoring quality audits.
-Examines and evaluates the accuracy of transactions processed by reviewing policy, procedure and manual input in accordance with guidelines.
-Tracks, trends and reports audit results to management.
-Identifies and communicates training issues and assists in developing corrective action plans.
-Runs and monitors monthly reports from database to identify and/or correct any incorrect data.
Requires a High School diploma or GED; 5 years of experience in health care, medical terminology and coding, 2+ years of related experience; or any combination of education and experience, which would provide an equivalent background.
-Experience working in a healthcare environment required
-Knowledge of QM preferred
-Computer skills: MS Office (Work, Outlook, Excel)
-Professional, organized, attention to detail, time management skills required.
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 antheminc.com/careers.
An Equal Opportunity Employer/Disability/Veteran