Anthem, Inc. Director, Clinical Quality Management in Indianapolis, Indiana
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 benefits companies and a Fortune Top 50 Company.
The health and safety of Anthem associates and the various stakeholders we service is a top priority for our business every day. Anthem’s workplace of the future will be both physical and virtual with the number of sites optimized to promote access to diverse, top talent.
Open to any Anthem office location.
The Director, Clinical Quality Management role is responsible for overseeing the development of supplemental HEDIS quality improvement strategies for the enterprise and/or clinical program development for population-based clinical quality measures. Primary duties may include, but are not limited to: • Directs the development of a national supplemental data quality plan and the integration of quality into the overall business process. • Evaluates industry best practices, medical research, and other resources to develop clinical programs and tools which facilitate and support quality, cost-effective care. Develops and implements an annual supplemental data plan detailing the strategies, programs and tools to be implemented. • Assures compliance with corporate supplemental HEDIS QI work plans. • Assures that all QI activities are relevant to the needs of targeted population. • Maintains documentation of research programs to meet regulatory and Accreditation Standards. • Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of results of data analysis. • Tracks supplemental HEDIS program performance and results. • Works with both internal and external customers to promote understanding of health services activities and objectives and to prioritize projects according to corporate, regional, and departmental goals. • Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires a BA/BS in a clinical or health care field (i.e. nursing, epidemiology, health sciences); 5 years of management experience in a health care environment; or any combination of education and experience, which would provide an equivalent background. MS or advanced degree in a health care related field (i.e. nursing, health education) or business preferred. • Previous experience working with NCQA, and HEDIS • Previous experience working with HEDIS Supplemental data. • Previous experience working with Supplemental data retrieval, abstraction, and over-reading. • Previous experience with HEDIS Supplemental data sources and standard vs non-standard data • Expert knowledge with HEDIS tech specs as it relates to HEDIS Supplemental data
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. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.