Anthem Provider Engagement Program Manager - Remote - PS11450 in Montebello, California

Provider Engagement Program Manager - Remote - PS11450

New

Location: California, United States

Field: Medical

Requisition #: PS11450

Post Date: Sep 14, 2018

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.

Serves as a primary contact with providers for engagement in all quality and revenue initiatives including HEDIS, CMS STARs, Risk Adjustment, CAHPS/HOS, coding and documentation. Manages Medicare Advantage quality improvement activities for provider groups in the West Region, focusing on CA with potential support for other markets (WA, CO, TX, NM) as needed. Primary duties may include, but are not limited to:

  • Developing and maintaining provider work plans for improved quality of care outcomes.

  • Organizing and facilitating monthly and quarterly meetings with providers as well as Joint Operating Committees (JOCs) and interim contact as required.

  • Collaboration with associated Anthem teams to reach overall member quality goals and metrics.

  • Assures compliance with corporate QI work plans.

  • Provides oversight, prioritization and analysis of clinical and administrative data with regular presentation of ongoing data analysis results to leadership.

  • Participates in and provides input to the development of new processes for the implementation of key initiatives.

  • Assists team members according to individual knowledge and skills.

  • Travel (local and overnight); Up to 50%

Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality 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.