Director I GBD Quality Management - Plan

Description

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.

Director I GBD Quality Management – Plan

Work Location – Must reside or relocated to Tennessee

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 state 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.

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. MSN, MPH, or MPA preferred. Current clinical license preferred. CQM experience in a Managed Care Organization preferred.

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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.