Job Details

ID #41233709
State California
City Paloalto
Full-time
Salary USD TBD TBD
Source Anthem, Inc.
Showed 2022-05-19
Date 2022-05-20
Deadline 2022-07-19
Category Et cetera
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Clinical Quality Program Manager

California, Paloalto, 94303 Paloalto USA

Vacancy expired!

Description SHIFT: Day JobSCHEDULE: Full-timeTitle: Clinical Quality Program Manager Location: 50% Hybrid. Buffalo, NY-office-based. Virtual Start. Must be within 50 miles from the office. Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact? How you will make an impact: Responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one or more states within a major line of business.

Primary duties may include, but are not limited to:

Coordinate and manage activities/projects for HEDIS chart collection, retrieval, abstraction and ensure weekly updates to senior leadership team.

Communicate with provider offices, clinics and hospitals for Quality-of-Care investigations and conduct chart review.

Support annual audit projects requiring clinical chart review and presentation of data and findings.

Manage Quality Improvement projects to improve New York State (HEDIS®/QARR®) measures.

Works with the clinical intervention teams to design studies to identify barriers to medical interventions.

Participate in state-level quality improvement project meetings, develop a quality workplan, and ensure integration of quality into the overall business process.

Lead interactions with regulators or oversight entities.

Assures that all QI activities are relevant to the needs of targeted population.

Maintains effective documentation of quality improvement activities to meet regulatory and accreditation standards.

Qualifications Minimum Qualification: Requires a BS in health administration, nursing, or a related clinical field.

4 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, certification in applicable field (i.e. CPHQ) and/or a MS in the health field (i.e. Nursing) is preferred.

Preferred Qualification

HEDIS®/QARR® experience preferred

Program/Project management

Clinical quality data analysis

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

REQNUMBER: PS73153-California

Vacancy expired!

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