Washington, United States Anthem, Inc. Full time
MILITARY VETERANS
Description
SHIFT: Day Job
SCHEDULE: Full-time
Your Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were 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.
Director Quality Management Plan Medicaid
Location: Washington DC
Anthem supports a hybrid workplace model with pulse point sites used for collaboration, community, and connection. Position is currently remote until our return to office is implemented, which at that point, position will be part of our hybrid workplace model.
Director Quality Management Plan Medicaid is responsible for driving the development, coordination, communication, and implementation of a strategic clinical quality management and improvement program within assigned health plan.
Primary duties may include, but are not limited to:
- Directs and provides leadership for implementing, monitoring and evaluating the Quality Management Program for the health plan.
- Promotes understanding, communication, and coordination of the quality management program.
- Directs and provides leadership for compliance with National Committee for Quality Assurance (NCQA) standards.
- Provides leadership for the interpretation of results and development of improvement action plans arising from provider and member satisfaction surveys.
- Serves as a resource for the design and evaluation of process improvement plans/quality improvement plans and ensures they meet Continuous Quality Improvement (CQI) methodology and district contractual requirements.
- Collaborates with other leaders in developing, monitoring, and evaluating Healthcare Effectiveness Data Information Set (HEDIS) improvement action plans, year round medical record review, and over read processes.
- Monitors and reports quality measures per state, Centers for Medicare and Medicaid Services (CMS), and accrediting requirements.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Qualifications
Minimum Requirements:
- Requires a BA/BS in a health or business related field; 8 years of experience in a healthcare environment, including prior management experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
- MSN, MPH, or MPA preferred.
- Current clinical license preferred.
- CPHQ Certification preferred.
- CQM experience in a Managed Care Organization highly desired.
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. All offers of employment are conditioned on completion of a background check, including COVID-19 vaccination verification. 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 100 Best Companies to Work For, is ranked as one of the 2020 Worlds Most Admired Companies among health insurers by Fortune magazine, and a 2020 Americas Best Employers for Diversity by Forbes. 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 race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.