SHIFT: Day Job

SCHEDULE: Full-time

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. 

We are hiring for a Care Consultant for our Medicaid Health Plan based out of our Buffalo, NY office. 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.  

Preference given to candidates residing within New York State and/or within driving distance to an Anthem office.

LOCATION – Buffalo, New York (REMOTE – must reside in NY)

Care Consultant
The Care Consultant oversees, plans and implements new and existing healthcare quality improvement initiatives and education programs specific to provider networks; ensures the maintenance of Quality Improvement Programs in accordance with state regulatory projects; conducts data collection, reporting and monitoring for key performance measurement activities. 

Primary duties may include, but are not limited to: 
•    Implements key quality and population health strategies alongside providers and with direction from the Director- Quality Management and Health Plan leadership to support practice implementation of quality improvement programs.
•    Actively participates in developing quality measure gaps in care reports, quality improvement program recommendations and action plans.
•    Obtains and analyzes quality metrics and reports, and provides education for practices to develop expertise with metrics. 
•    Facilitates provider engagement meetings to help practices identify areas of need and shares scorecards for providers to improve quality measures and the patient experience.
•    Maintains up to date knowledge on New York State Quality Assurance Reporting Requirements (QARR) specifications, and supports Performance Improvement Projects.
•    Leads collaborative population health improvement initiatives, quality improvement efforts and discussions with other departments within the organization. 
•    Participates in Quality Improvement workgroups including Behavioral Health, Chronic Disease and Maternal/Child Health workgroups to improve statewide performance and STAR ratings. Assist quality improvement workgroups by supporting monthly tracking of workplan activities.
•    Assist the accreditation team with Continuity and Coordination of care Standards and any tasks related to the completion of the Quality Improvement program description, workplan and annual evaluation
•    Tracks progress of quality improvement programs and prepares status reports to management or senior management. 

This role will support the HEDIS project team in the following ways
•    Subject matter expertise and contribute to support chart retrievals, supplemental data collection for performance improvement and assist with following up with regional providers.
•    This position will require a strong knowledge of specifications and criteria for record collection and regional provider contacts. 

Qualifications

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.

Minimum Qualifications:
•    Requires a BA/BS and a minimum of 3 years health care experience; or any combination of education and experience, which would provide an equivalent background. 

Preferred Qualifications:
•    Physician environment experience in practice transformation/quality improvement measures (HEDIS/NCQA/QARR), ambulatory care setting quality and efficiency metrics, and electronic health records strongly preferred.
•    Prior health plan and Medicaid experience is 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.