Practice Consultant

Description

Practice Consultant
Location: any west region state, but prefer AZ, NV, NM


Be part of an extraordinary team
We 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?



How you will make an impact
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.
• Assigned providers for chart collection, HEDIS measure education, and deliver gap report.
• Supporting centralized hybrid project with chart abstraction, overreading, and chart research as needed.
• 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.

Qualifications

Minimum Requirements:

• 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.

Preferred Skills, Capabilities and Experiences:

• BSN or MSN.
• Medical record review and supplemental data.
• Managed care background.

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 ability@icareerhelp.com for assistance.