Anthem, Inc. Care Consultant Sr. in Hanover, Maryland
SHIFT: Day Job
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.
This is a work at home opportunity. Due to the current COVID-19 (coronavirus) pandemic, this position will require you to work remotely with providers from your home with the expectation that travel to a designated territory will be required post COVID. You must live within a 50 mile commutable distance of an Anthem office location.
The Care Consultant Sr. role is responsible for consulting with providers to improve the effectiveness and efficiencies of provider practices through quality improvement and specific cost metrics. Primary duties may include, but are not limited to: • Obtains and analyzes quality metrics and reports for care opportunities, supports practice implementation of care coordination and care management, identifies action plans for providers to implement to improve cost, quality and the patient experience and participates in design, development, and implementation of community learning forums. • Collaborates with other internal departments such as provider relations, contracting, quality, medical directors and financial analysts to collectively support the provider in their Value based Contract. • Actively participates and leads in the development of action plans and recommendations for participation in value based programs for provider groups. • Makes recommendations to providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients. • Promotes practice transformation to team based patient centered care delivery. • Provides education for practices to develop expertise with metrics and data review for quality improvement. • Actively participates in various community and multi-department committees to assure effective program implementation. • Tracks progress of program and prepares status reports to management or senior management. • Interacts and leads large meetings with practice staff including physicians, clinical and administrative staff
Requires a BA/BS; 5 years health care experience; or any combination of education and experience, which would provide an equivalent background.
• Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, and electronic health records preferred.
• Strong financial analysis skills preferred as well as strong presentation experience and excellent communication skills.
• Ability to be self-motivated and think outside the box to reach goals.
• Organized, self-starter with attention to both big picture goals and details preferred. • Knowledge of provider office operations helpful. • Previous experience with multiple lines of business (Medicaid, Medicare and Commercial) is a bonus.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
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