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Clinical Quality Auditor Ld

Location: Chicago, IL
JobFamily: Medical
Req #: PS63720
Date Posted: Nov 24, 2021

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Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

Job Descriptions:

Responsible for participating in non-clinical quality management activities that ensure programs meet accreditation and regulatory standards. Primary duties may include, but are not limited to:

  • Prepares team for internal audits which may include oversight audits, same state licensure requirements, verbal notifications, internal operation processes
  • Conducts audits of Quality Management (QM), regulatory, compliance processes and files
  • Prepares corrective action plans in response to oversight audits of AIM.
  • Issues corrective action plans in response to audits performed by quality department
  • Writes policies and procedures and assists with development of audit tools and guidelines.
  • Assists manager with day-to-day monitoring and prioritizing of workflows and activities.
  • Develops and improves departmental processes and operations.
  • Monitors goals, performance and processes.
  • Assists with issues of non-compliance.
  • Mentors and coaches staff.
  • Trains new associates and re-trains current associate.
  • Monitors and prioritizes workflows. Serves as a resource and a subject matter expert.

Qualifications

Job Qualifications:

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid 19. All offers of employment are conditioned on completion of a background check, including COVID 19 vaccination verification. If you are not vaccinated, your offer will be rescinded unless you provide and Anthem approves a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably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

  • Requires BS in health sciences, health management or a related field and minimum of 5 years of experience in utilization management, quality assurance and/or regulatory/accreditation standards/audits which includes a minimum of 3 years of quality management experience; or any combination of education and experience, which would provide an equivalent 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.

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.