Vacancy expired!
Practice ConsultantLocation: United StatesNewRequisition #: PS29783Your 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.NOTE: This is not a "consulting" position. It is a full-time employee w/benefits position. This position will work remote in the OH area.The Practice Consultant is responsible for creating a partnership relationship with providers to implement quality measures, value based provider groups, risk revenue, cost of care initiatives and STAR ratings for a fully integrated and accountable system of care. Primary duties may include, but are not limited to:
Assesses current practice patterns, assets and challenges utilizing STAR measures, NCQA Standards, HEDIS audits, site reviews and medical records reviews.
In partnership with the PCP, evaluates results of the initial assessment.
Establishes a project plan with the practice that establishes goals and objectives for improvement.
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 population and the care givers.
Requires an AS/BS in nursing or other clinical license; 5 years of managed care experience; 2 years of clinical experience; 2 years of professional presentations to small and large audiences; or any combination of education and experience, which would provide an equivalent background.
Current, unrestricted clinical license (LPN, RN, NP, PA, LCSW) is preferred.
BSN or MSN preferred.
HEDIS experience
Experience doing presentations to individuals or groups preferred.
An understanding of RAF (risk adjustment factor) preferred.
Medical record review and coding experience preferred.
Ability to travel locally to meet with physicians and physician groups on a regular basis.
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 antheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran
Vacancy expired!