Director I Clinical Quality & Provider Liaison (Northern Region) - 123252
Rancho Cordova, California
January 31, 2017
Position Type:
Full Time
Health Care
Y/our Talent. Our Vision./ At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater 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.

Responsible for developing, coordinating, communicating, and implementing a strategic clinical quality management and improvement program for Northern California Region Health Plans. Primary duties may include, but are not limited to:

Promotes broad understanding, communication, and collaboration with enterprise-wide leaders to ensure appropriate communication, integration, and utilization of best practices.
Oversees internal Quality Management (QM) Scorecard reporting and Gaps in Care.
Oversees Health Employer Data Information Sets (HEDIS) reporting and the development of action plans to achieve target improvement goals.
Provides leadership for QM representation in new business activities.
Supports compliance with National Committee for Quality Assurance (NCQA) standards or other accrediting bodies.
Provides leadership for the development, implementation, and evaluation of Clinical Quality improvement action plans to improve quality measures for the Northern California Region.
Develop interventions to impact quality scores.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Oversee interface with delegated groups and providers on improving quality scores.

Requires a BA/BS in a health or business related field; 10 years of experience in a healthcare environment, including prior management experience; or any combination of education and experience, which would provide an equivalent background.
MSN, MPH, or MPA preferred. CQM experience in a Managed Care Organization strongly preferred.
Population health management and/or clinical quality program development experience preferred.
Health Plan, managed care organization or provider management group experience required.
Schedule Expectations:

+ 60% travel within California
+ 20% work at home
+ 20% in the office

EOE. M/F/Disability/Veteran.

// Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran. //

Job Medical

Title: Director I Clinical Quality & Provider Liaison (Northern Region) - 123252

Location: CA-Rancho Cordova

Requisition ID: 123252

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