Anthem Inc. Medical Jobs

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Anthem, Inc. HEDIS Lead in North Miami Beach, Florida


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 care companies and a Fortune Top 50 Company.

Location: Florida; can be Remote in the State of Florida: Must live within 60 miles or 1 hour of an Anthem office.

The HEDIS Lead is responsible for coordinating, implementing, and executing HEDIS Quality Department specific projects, ensuring consistency with company strategy, commitments, and goals.

What does a typical day look like?

Primary duties may include, but are not limited to:

  • Leads annual completion of the HEDIS Roadmap, to include audit support and representation.

  • Support the medical record collection and abstraction process; synthesizes aggregate plan and product level data medical record data; data gathering, presentation, and interpretation for optimal HEDIS data/results.

  • Prepares and maintains project plans and schedules inclusive of tasks, timelines, resources, milestones, dependencies, and assumptions.

  • Leads teams regarding work flow process improvement, document management, and abstraction education.

  • Responsible for the CHCUP/EPSDT Reporting as well as any agency defined performance measures by the State.

  • Evaluates and monitors performance and efficiency of programs to ensure that implementation meets targeted timelines.

  • Collaborates with internal departments and external provider to maximize quality performance outcomes and higher overall compliance.


What You Contribute:

  • Requires an AD in healthcare field; 2+ years of experience with HEDIS activity coordination or working with Managed/Acute/Provider Care environment, including 2+ years of analytical experience; or any combination of education and experience, which would provide an equivalent background.

  • BA/BS preferred.

  • RN, RHIA or RHI license strongly preferred.

  • NCQA and HEDIS experience strongly preferred.

  • Knowledge of Medicare and Medicaid is required for both LOB

  • Experience with EPSDT strongly preferred

    What We Have to Offer:

    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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at 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.

    REQNUMBER: PS51472