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Anthem, Inc RN Practice Consultant HEDIS (PS14635) - Western Region of the US in Charlotte, North Carolina

RN Practice Consultant HEDIS (PS14635) - Western Region of the US

Location: United States

Field: Medical

Requisition #: PS14635

Post Date: Mar 12, 2019

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.

Practice Consultant (PS14635)

Position Location – Must reside in either: California, Texas, Colorado, New Mexico or Washington

Responsible for creating a partnership relationship with providers and other initiatives and implementing the concept of a Medical Home for our members to achieve this fully integrated and accountable system of care. Primary duties may include, but are not limited to:

o Request medical records and conduct HEDIS medical chart reviews/abstractions.

o Review and perform quality audits of supplemental data and Clinical Practice Guidelines.

  • 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.

  • Provider and member engagement experience required

Requires an AS/BS in nursing; 5 years of managed care experience; 2 years of clinical experience; 3 YEARS OF HEDIS 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 appropriate to field of specialty (LVN/LPN, RN, NP, PA, LCSW, LSW, etc.) as required. BSN or MSN 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.

An Equal Opportunity Employer/Disability/Veteran