Anthem RN Provider Clinical Liaison - Oncology Solutions - CO, NV or CA - Remote must be located within 2-hour drive from Anthem office (PS 11852) in Las Vegas, Nevada

RN Provider Clinical Liaison - Oncology Solutions - CO, NV or CA - Remote must be located within 2-hour drive from Anthem office (PS 11852)

New

Location: Los Angeles, California, United States

Field: Medical

Requisition #: PS11852

Post Date: 1 day ago

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater 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.

Title: Provider Clinical Liaison

Location: Can be located in CA.CO, NV is an option with on-site orientation. Candidate has to be located within 2-hour drive from an Anthem office.

Hours: Standard Business Hours Monday-Friday.

Responsible and accountable for partnering and building relationships with practices, providers and their office staff to support and enhance understanding of the Cancer Care Quality Program, advanced illness care and other strategic initiatives touching cancer patients, to influence behavior changes in improving key quality and performance measures that will have a substantial impact on member health outcomes as well as the value of healthcare.

Primary duties may include, but are not limited to:

  • Serves as the clinical point of contact for practices, providers and staff for orientation, on-going training, practice transformation and support to strengthen collaborations and improve participation in Anthem Cancer Care Quality Program, and related clinical programs or initiatives touching members with cancer.

  • Analyzes practice specific quality and key performance metrics (such as pathway adherence) regularly to identify opportunities for improvement. Conducts quarterly (or more frequent) clinical review meetings with physicians, key practice leaders, and office staff–sharing practice specific data, state and national benchmarks to identify opportunities to grow participation, improve quality measures, and motivate practice transformation changes.

  • Frequently follow-up and monitor practice performance.

  • Works in collaboration with the oncology team and other business partners on program review, evaluation and program design enhancements.

  • Serves as the subject matter expert for practices on all Anthem programs for all lines of business and other care management initiatives (i.e. advance illness, precision medicine, genetics).

  • Partners with key departments, e.g. AIM Specialty Health, Total Population Health, Provider Solutions, Provider Enablement, Claims, etc. to facilitate clinical and operational processes between the company and provider offices. Serves as a liaison with state / region provider contracting account managers and other associates.

This position requires traveling of approximately 35% of the time.*

  • A BA/BS in Nursing; 5 plus years of oncology practice and physician dynamics and work flow experience with deep understanding of practice transformation/quality improvement, revenue cycle management, EMR/EHR applications and workflow impact, quality and efficiency metrics, and data analytics experience or any combination of education and experience, which would provide an equivalent background.

  • MS or advanced degree preferred.

  • Current unrestricted RN license in CA, CO or NV required.

  • Advanced knowledge of oncology care is highly desired.

  • 35% travel time required.

  • Strong communication and presentation skills and ability to think critically required.

  • Advanced knowledge of MS Applications (e.g. Excel and PowerPoint, etc.) highly desired.

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.