Anthem, Inc. Practice Consultant in Canton, Ohio
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 care companies and a Fortune Top 50 Company.
Preferred Location: Remote within a commutable distance to an Anthem office in one of the central states: IN, KY, MO, OH, TN, WI, LA, IA
The Practice Consultant is responsible for creating a partnership relationship with providers to improve HEDIS scores and reporting of HEDIS and other quality initiatives for our members to achieve this fully integrated and accountable system of care. Primary duties may include, but are not limited to:
Assesses current practice patterns, assets and challenges utilizing Medical Home
Index, NCQA Standards, HEDIS audits and medical records reviews.
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.
Ongoing medical record reviews and abstractions.
Improves the understanding and sensitivity to the unique needs of this population and the care givers.
The health and safety of our associates, members and communities is a top priority for Anthem. This priority has become increasingly important as we continue to face the challenges of the COVID-19 pandemic. Anthem believes vaccination is the best way to reduce the spread of COVID-19 and protect our members, our communities, our families and ourselves. To minimize the risk of transmission of the COVID-19 virus and maintain a safe and healthy workplace, vaccination is required for this role. (At Anthem, fully vaccinated means it has been at least two weeks since you have received the second dose of a two-dose vaccine such as Moderna or Pfizer, or the single dose of a single dose vaccine, such as Johnson & Johnson ).
If you do not meet the requirements for this position, we encourage you to review other positions that currently allow virtual work. If you have a medical or sincerely held religious reason for not being vaccinated, consistent with applicable law, Anthem will consider requests for reasonable accommodation on this basis. Should you have any questions regarding the requirement after applying, email TalentAcquisition_VaccinationSupport@anthem.com .
Requires AS in nursing and minimum of 5 years of managed care experience and minimum of 2 years of clinical experience and minimum of 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 (LVN/LPN, RN, NP, or PA) appropriate to field of specialty as required.
You must reside in one of the central states: IN, KY, MO, OH, TN, WI, LA, IA
A minimum of 3 years of HEDIS experience
Medical record review experience required.
May require occasional local travel.
Managed care and/or Medicare experience preferred.
BSN or MSN preferred.
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.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For® , is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.