DescriptionSHIFT: 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.
The Practice Consultant is 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.
- 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 in program implementation of community-based services preferred
- Understanding of specific needs and challenges of high- risk populations: Homeless, High Utilizers, SMI/SUD, Nursing Facility transition to community, LTC at risk for institutionalization; Incarcerated transition to community, and high-risk children and youth 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.
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. 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.
Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.