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Description SHIFT: Day JobSCHEDULE: Full-timeYour 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.Staff VP HEDIS Medical Record ReviewLocation: Must reside near an Anthem officeResponsible for strategic leadership and oversight of enterprise-wide Health Employer Data Information Set (HEDIS) Medical Record Review (MRR) management and reporting. Primary duties may include, but are not limited to:
Develops and implements an annual HEDIS MRR strategy and model to be applied across all lines of business ensure proper enterprise-wide processes are in place for HEDIS data collection.
Researches applicable subject matter practices and remains aware of industry standards and trends related to HEDIS Specifications and reporting to ensure design and implementation of best practices.
Oversees processes to ensure compliance with all HEDIS CMS, NCQA and state standards.
Leads HEDIS audits and manages enterprise-wide HEDIS projects and readiness.
Hires, trains, coaches, counsels, and evaluates the performance of direct reports.
Qualifications
Requires a BA/BS degree in a clinical or health care field (i.e. nursing, epidemiology, health sciences); 8 years of management experience in a health care environment, including National Committee for Quality Assurance (NCQA) and HEDIS; or any combination of education and experience, which would provide an equivalent background.
Knowledge of NCQA and HEDIS required.
MS or advanced degree in a health care related field (i.e. nursing, health education) and current license (i.e. RN) are preferred.
Excellent communication skills.
Previous HEDIS MRR experience 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.REQNUMBER: PS36866
Vacancy expired!