Anthem Inc. Medical Jobs

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Anthem, Inc. HEDIS Practice Consultant - Medicare Central in Columbus, Ohio

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

Title: Practice Consultant (Medicare Central).

Location: Remote in one of the central states: OH, IN, KY, MO, TN, WI.

The Practice Consultant is responsible for creating a partnership relationship with providers to improve HEDIS scores and reporting of HEDIS and other quality initiatives for our members to achieve this fully integrated and accountable system of care.

Primary duties may include, but are not limited to:

  • Assesses current practice patterns, assets and challenges utilizing Medical Home.

  • Conducts Index, NCQA Standards, HEDIS audits and medical records reviews.

  • Partners with the PCP, may evaluate results of the initial assessment.

  • Establishes a project plan with the practice that establishes goals and objectives for improvement.

  • Provides ongoing practice support and sustains the partnership.

  • Establishes regular meetings to track progress.

  • Ongoing medical record reviews and abstractions.

  • Improves the understanding and sensitivity to the unique needs of this population and the care givers.

Qualifications

Requires:

  • AS/BS in nursing or similar field; a minimum of 3 years of HEDIS experience; 2 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.

  • Must reside in one of the central states: OH, IN, KY, MO, TN, WI.

  • Current, unrestricted clinical license (LVN/LPN, RN, NP, or PA) in the state in where you reside is required

  • BSN or MSN preferred.

  • Experience with chart auditing/review and quality assurance highly preferred.

  • Managed care and/or Medicare experience preferred.

  • May require occasional local travel to expos and events.

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. Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2019 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.

REQNUMBER: PS43716-Ohio

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