Practice Consultant

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.
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.
 

Duties & Responsibilities:
Practice Consultant 
Location: Waukesha, Wisconsin
Hours of Operation: Monday – Friday 8:30 a.m. – 5 p.m. 
Responsible for creating a partnership relationship with providers and other initiatives and implementing the concept of a Medical Home for our members to achieve this fully integrated and accountable system of care. Primary duties may include, but are not limited to: 
•    Assesses current practice patterns, assets and challenges utilizing Medical Home Index, NCQA Standards, HEDIS audits, site reviews and medical records reviews. 
•    In partnership with the PCP, evaluates results of the initial assessment. 
•    Establishes a project plan with the practice that establishes goals and objectives for improvement. 
•    Provides ongoing practice support and sustains the partnership. 
•    Establishes regular meetings to track progress.
•     Identifies and facilitates at least one practice in each MPC region to become SSB Physician Champions by obtaining NCQA certification as a Patient Centered Medical Home. 
•    Improves the understanding and sensitivity to the unique needs of this population and the care givers.
•    Assesses quality performance of the OBGYN practice, identify opportunities for improvement, asses current practice patterns, assets and challenges, NCQA Standards, HEDIS audits, medical records reviews and site reviews preferred.
•    In partnership with the OB, evaluates quality opportunities for implementation by establishing a project plan with the practice that identifies goals and objectives for improvement preferred.
•    Provides ongoing practice support and sustains the partnership preferred.
•    Establishes regular meetings to track progress preferred.
•    Improves the understanding and sensitivity to the unique needs of this population and the care givers preferred.
•    Successful candidate will be adept at data interpretation with ability to develop and implement a quality plan to achieved preferred.

Qualifications

Requirements:
Practice Consultant 

•    Requires AS in nursing and minimum of 5 years of managed care experience and minimum of 2 years of clinical experience and minimum of 2 years of professional presentations to small and large audiences; or any combination of education and experience, which would provide an equivalent background.
•     Current, unrestricted clinical license appropriate to field of specialty (LVN/LPN, RN, NP, PA, LCSW, LSW, etc.) as required.
•     BSN or MSN preferred.
•    Experience with provider operations preferred  
•    Experience with maternal and child health preferred  
•    HEDIS experience also 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 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. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.