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Clinical Quality Program Manager

Anthem, Inc

This is a Full-time position in Laveen, AZ posted May 13, 2022.

Description SHIFT: Day JobSCHEDULE: Full-timeClinical Quality Program Manager Schedule: Monday-Friday; 8am-5pm Location: RemoteBe part of an extraordinary teamWe are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change.

Do you want to be part of a larger purpose and an evolving high-performance culture that empowers you to make an impact?This role has options of duties depending on the selected managerDuties & Responsibilities 1 Responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one or more states within a major line of business.

Primary duties may include, but are not limited to:
• Leads state level quality strategy meetings, develops a quality plan, and ensures integration of quality into the overall business process.

• Works with the clinical intervention team to design studies to identify barriers to medical interventions.

• Ensures that study methodology is sound and appropriate reporting is in place.

• Develops performance improvement plans and oversees the clinical quality improvement activities/projects to improve the quality of care for members.

• Assures compliance with corporate QI work plans.

• Assures that all QI activities are relevant to the needs of targeted population.

• Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.

• Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of data analysis results.

• Participates in and provides input to the development of new product designs for major line of business.

• Oversees the implementation of new initiatives.

• Leads interactions with regulators or oversight entities.

• Oversees quality improvement activities for the largest, most complex state programs.2 (additional duties)
• Schedules and/or leads state/regional level quality strategy meetings, develops a quality plan, and ensures integration of quality into the overall business process.

• Collects data from quality databases, uses tools/applications to effectively analyze and interpret findings, as well as prepare applicable materials/overviews
• Maintains effective documentation meeting results and action plans, and conducts prep sessions and follow-ups with assigned owners to ensure achieve desired outcomes
• Support NV, AZ, NM, and WA provider groups3 (additional duties)Responsible for regional programs, both provider and member facing, with data analysis and interpretation.Primary duties may include, but are not limited to:
• Conducts analyses of HEDIS data and programs to identify opportunities and determine efficacy.

• Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of data analysis results.

Qualifications Requirements
• Requires a BS in health administration, nursing, or a related clinical field
• 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.

• Current unrestricted license, certification in applicable field (i.e.

CPHQ) and/or a MS in the health field (i.e.

Nursing) is preferred.

Project management experience or certification; skilled in Excel, PowerPoint, and Word preferred.

Proficiency in database development/management preferred.

Experienced in quality or health care analysis.

Knowledge and experience in population or public health a plus 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.

The health of our associates and communities is a top priority for Anthem.

We require all new candidates to become vaccinated against COVID-19.

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.

Anthem, Inc.

has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion.

To learn more about our company and apply, please visit us at careers.antheminc.com.

Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact abilityicareerhelp.com for assistance.

REQNUMBER: PS67836-Texas