Monday , May 27 2024

Anthem Careers – Director Clinical Quality

Website Anthem

Job Description:

Responsible for working with the Staff VP of health care management to direct the team responsible for clinical quality initiatives, including NCQA accreditation and compliance with regulatory agencies, and leading the team responsible for improving HEDIS and CAHPS interventions to achieve the 75th percentile for each measure.

Job Responsibilities:

  • Maintains expert knowledge of current NCQA standards, quality improvement activities, and strong medical management skills.
  • Works with both internal and external customers to promote understanding of health services activities and objectives within the company and to prioritize departmental projects according to Anthem corporate, regional, and departmental goals and in accordance with the Blue Cross Blue Shield Director’s Office regulations and project priorities.
  • Hires, trains, coaches, counsels, and evaluates the performance of direct reports.
  • Assures the training and continuing education of staff regarding standards and guidelines, including NCQA and HEDIS, and support team members with achieving career goals.

Job Requirements:

  • Requires BA/BS in a clinical or health care field (i.e. nursing, epidemiology, health sciences) and 5 years progressively responsible management experience in a health care environment or any combination of education and experience, which would provide an equivalent background.
  • MS or advanced degree in a healthcare-related field (i.e. nursing, health education) or business strongly preferred.
  • Previous experience working with NCQA, and HEDIS preferred.

Job Details:

Company: Anthem

Vacancy Type:  Full Time

Job Location: Albany, NY, US

Application Deadline: N/A

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