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Anthem, Inc. Director l - GBD - HEDIS - Quality Managment - Plan - $5,000 Sign On Bonus in West Covina, California

Director l - GBD - HEDIS - Quality Managment - Plan - $5,000 Sign On Bonus

Location: California, United States

Requisition #: PS30992

Post Date: Dec 06, 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 healthcare .

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.

This position offers a $5,000 sign on bonus. Position will sit in either one of Anthem’s California or Texas offices. HEDIS, health promotion experience highly preferred.

Responsible for driving the development, coordination, communication, and implementation of a strategic clinical quality management and improvement program within assigned health plan.

Primary duties may include, but are not limited to:

  • Directs and provides leadership for implementing,monitoring and evaluating the Quality Management Program for the health plan.

  • Promotes understanding, communication, andcoordination of the quality management program. Directs and provides leadershipfor compliance with National Committee for Quality Assurance (NCQA) standards.

  • Provides leadership for the interpretation ofresults and development of improvement action plans arising from provider andmember satisfaction surveys. Serves as a resource for the design and evaluationof process improvement plans/quality improvement plans and ensures they meetContinuous Quality Improvement (CQI) methodology and state contractualrequirements.

  • Collaborates with other leaders in developing,monitoring, and evaluating Healthcare Effectiveness Data Information Set(HEDIS) improvement action plans, year round medical record review, and overread processes. Monitors and reports quality measures per state, Centers forMedicare and Medicaid Services (CMS), and accrediting requirements. Hires,trains, coaches, counsels, and evaluates performance of direct reports.

Requires a BA/BS in a health or business related field; 8+ years of experience in a healthcare environment, including prior management experience; or any combination of education and experience, which would provide an equivalent background.

HEDIS, health promotion experience highly preferred.CQM experience in a Managed Care Organization highly preferred.

MSN, MPH, or MPA preferred. Current clinical license preferred.

An Equal Opportunity Employer/Disability/Veteran

Anthem, Inc. is ranked as one of America’sMost 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 andapply, please visit us at An Equal Opportunity Employer/Disability/Veteran.