Anthem Manager I GBD Quality Mgmt - HEDIS Experience Required - Remote in IA - PS9071 in West Des Moines, Iowa

Manager I GBD Quality Mgmt - HEDIS Experience Required - Remote in IA - PS9071

New

Location: Iowa, United States

Field: Medical

Requisition #: PS9071

Post Date: Jul 09, 2018

Your Talent. Our Vision . At Amerigroup , a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s 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.

Manager I GBD Quality Management – Remote in IA with 550% of travel

Responsible for developing, coordinating, and implementing clinical quality initiatives within the health plan. Provides process and technical supervision to a team responsible for monitoring and evaluating the quality of care/service, appropriateness, continuous improvement, member satisfaction, and results of actions across the continuum of care to members. Primary duties may include, but are not limited to:

  • Assists in establishing Quality Management objectives and annual goals.

  • Implements the comprehensive Quality Management Program to meet the demographic and epidemiological needs of the population served.

  • Promotes plan-wide understanding, communication, and coordination of the quality management program.

  • Trends quality data and develops aggregate and individual plan reports as indicated; analyzes validity of data/reports.

  • Coordinates the development, implementation, and evaluation of quality improvement action plans.

  • Coordinates the state regulatory quality reporting for the health plan.

  • Hires, trains coaches, counsels, and evaluates performance of a team of RNs.

  • 550% travel required depending on the business needs. It could be traveling statewide during HEDIS season, traveling to the local provider offices or West Des Moines office.

Qualifications:

  • Requires an Associate’s degree; 5 years of experience in quality improvement and/or utilization review in HMO setting, including prior management experience; or any combination of education and experience, which would provide an equivalent background.

  • Requires Healthcare Effectiveness Data Information Set (HEDIS) reporting experience.

  • Strongly preferred current unrestricted RN, PA or MD licensure in the state of Iowa.

  • At least 2 years’ experience in managing HEDIS project(s) strongly preferred.

  • Experience with providers’ or physicians’ offices education strongly preferred.

  • Previous people management/supervisory experience strongly preferred.

  • Experience with National Committee for Quality Assurance (NCQA) preferred.

  • Requires strong Presentation (PowerPoint) skill and Interpersonal skill.

  • Coding (ICD-10) – CPT experience preferred.

  • Previous experience in managing a team of registered nurses preferred.

  • Medicaid population experience preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers at http://www.wellpoint.com/careers . EOE. M/F/Disability/Veteran.