Modesto, CA, United States
Manager I Special Programs Clinical Quality Management PS24605
Location: Norfolk, Virginia, United States
Requisition #: PS24605
Post Date: 17 hours ago
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.
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 benefits companies and a Fortune Top 50 Company.
Manager I Special Programs, Clinical Quality
This position must be located in an Anthem Office Norfolk, VA is preferred.
Responsible for managing and overseeing an outbound call center team responsible for coordination of a comprehensive health care program in which MEDICAID members and providers are called and preventive medical screenings are scheduled.
Primary duties may include, but are not limited to:
Manages resource utilization to ensure appropriate delivery of care to members in collaboration with providers.
Coordinates service delivery to include member assessment of physical and psychological factors.
Participates in cross-functional workgroups and departments created to maintain and develop program.
Evaluates current processes of Special Program's support functions; recommends changes for increased efficiencies and improved outcomes.
Develops and conducts training programs for staff involved in the program.
Extracts and manipulates analytical data to present findings to relevant markets and stakeholders.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires a BA/BS; 5 years of experience in a related field, including 1-2 years of leadership/management experience required; or any combination of education and experience, which would provide an equivalent background.
Knowledge of health plans required.
Experience in managed care organizations required.
Medicaid Quality Management, HEDIS, and STARs preferred.
Experience with providers preferred.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
Website : http://www.antheminc.com
The company was formed when WellPoint Health Networks Inc. and Anthem, Inc. merged in 2004 to become the nation's leading health benefits company. The parent company originally assumed the WellPoint, Inc. name at the time of the merger. In December 2014, WellPoint, Inc. changed its corporate name to Anthem, Inc. The Anthem brand is built on a foundation of trust – it’s the name consumers are most familiar with as a trusted health care partner through our affiliated health plans. Anthem, Inc. is one of the largest health benefits companies in the United States. Through its affiliated health plans, Anthem companies deliver a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, Anthem, Inc. is an independent licensee of the Blue Cross and Blue Shield Association serving members in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin; and specialty plan members in other states.