Anthem, Inc. Clin Qual Prog Consultant (Accreditation Consultant) in Westchester, Illinois
SHIFT: Day Job
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.
Clinical Qual Prog Consultant (Accreditation Consultant) - PS38238
Primarily responsible for assisting East Region health plans in achieving NCQA Accreditation. The Clinical Qual Prog Consultant is responsible for serving as a liaison with and overseeing the quality improvement activities and programs for one or more states within a major line of business.
Primary duties may include, but are not limited to:
Co-leads state level quality strategy meetings, develops a quality plan, and ensures integration of quality into the overall business process.
Works with the clinical intervention team to design studies to identify barriers to medical interventions.
Ensures that study methodology is sound and appropriate reporting is in place.
Develops performance improvement plans, and oversees the clinical quality improvement activities to improve the quality of care for members.
Assures compliance with corporate Quality Improvement (QI) work plans.
Assures QI activities are relevant to targeted population.
Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.
Oversees accurate and complete quantitative analysis of clinical data and presentation of results.
Requires a BS in health administration, nursing or a related clinical field; 3 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted license or certification in applicable field preferred (i.e. CPHQ).
MS in the health field (i.e. Nursing) 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.