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Practice Consultant (HEDIS) San Diego or Sacramento, CA Remote - PS31388Location: California, United StatesNewRequisition #: PS31388Your Talent. Our Vision. At An them, 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.Location: This position is eligible to work remote, but candidate must reside in or near San Diego, or Sacramento, CA (2 openings)The Practice Consultant responsible for creating a partnership relationship with providers and other initiatives and implementing the concept of a Medical Home for our members to achieve this fully integrated and accountable system of care. Primary duties may include, but are not limited to:
Creates partnerships with Provider groups to educate on HEDIS measures and best practices for gap closure
Conducts HEDIS medical chart reviews
Review and perform quality audits of supplemental data and Clinical Practice Guidelines
Provides ongoing practice support and sustains the partnership
Establishes regular meetings to track progress
Improves the understanding and sensitivity to the unique needs of this Medicare population
Supports the annual HEDIS Medical Record Review (MRR)
Facilitates presentations with Provider groups
Requires an AS/BS in nursing
2 years of clinical experience
2 years of professional presentations to small and large audiences
3 years of HEDIS experience
Current, unrestricted RN license in Texas
Previous experience with NCQA Standards, HEDIS audits, site reviews and medical records reviews
Experience supporting Diverse population
Ability to travel locally to provider locations is required
Bilingual: Spanish, Chinese, Vietnamese or Korean preferred
2-3 years managed care experience strongly 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/Veterans
Vacancy expired!