Clinical Quality Program Director
Company: Anthem, Inc.
Posted on: February 25, 2021
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variety of communications which may be sent to the email address
with which you apply Clinical Quality Program Director Your Talent.
Our Vision. At CareMore, a proud member of the Anthem, Inc. family
of companies, 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. CareMore is a proven care delivery model for the
highest-risk. We are a team of committed clinicians and business
leaders passionate about transforming American healthcare delivery.
We build and lead integrated, multi-disciplinary clinical teams to
care for the most complex patients. We strive for excellence and
have achieved significant and measurable improvement in total cost
of care, clinical outcomes, and experience. As an Anthem
subsidiary, we benefit from the scale and resources one of
America's largest managed healthcare organizations. Responsible for
developing a national quality improvement strategy for a major line
of business. Primary duties may include, but are not limited to:
- Leads enterprise-wide quality strategy meetings.
- Develops and facilitates the integration of a national Medicare
Star Ratings program strategy development, implementation and
oversight plan. --
- Identifies and integrates best practices into state programs to
drive Medicare Star Rating performance nationally.
- Develops performance improvement plans and oversees the
clinical quality improvement activities/projects.
- Participates in the development, management, review and
reporting of program outcomes for Medicare Star Ratings programs,
including HEDIS, Medication Adherence, Health Outcome Survey and
CAHPS measure performance.
- Assures compliance with corporate Quality Improvement work
- Ensures research program documentation meets regulatory and
- Assures accurate and complete quantitative analysis of clinical
- Leads cross-functional department projects and mentors
- Prepares and presents program documents to senior
- Monitors encounter/claims/other data reports to optimize STARS
performance. Qualifications Requires a BS in health administration,
nursing or a related clinical field; 5 years of health care quality
or data analysis experience; or an equivalent combination of
education and experience, which would provide an equivalent
background. Current unrestricted license or certification in an
applicable field (i.e. CPHQ) or MS in the health field (i.e.
Nursing) preferred. Experience managing Star Ratings or Quality
Management / HEDIS program, preferred. Knowledge of state or
assigned line of business needs and priority improvement areas
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. Please be advised that Anthem only accepts resumes from
agencies that have a signed agreement with Anthem. Accordingly,
Anthem is not obligated to pay referral fees to any agency that is
not a party to an agreement with Anthem. Thus, any unsolicited
resumes, including those submitted to hiring managers, are deemed
to be the property of Anthem. EEO is the Law Please use the links
below to review statements of protection from discrimination under
Federal law for job applicants and employees. Anthem, Inc. is
committed to helping individuals with disabilities participate in
the workforce and ensuring equal opportunity to apply and compete
for jobs. If you are an individual with a disability and require a
reasonable accommodation to complete the application process,
please email Human Resources at email@example.com for further
assistance. *WARNING : Please beware of phishing scams that solicit
interviews or promote work-at-home opportunities, some of which may
pose as legitimate companies. Please be advised that Anthem will
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our company. If you feel that you have been the victim of a scam
such as this, please report the incident to the Federal Trade
Commission here by selecting the 'Rip-offs and Imposter Scams'
option. Anthem requires a completed online application for
consideration of employment for any position.
Keywords: Anthem, Inc., Cerritos , Clinical Quality Program Director, Executive , Cerritos, California
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