Care Consultant Sr
DescriptionSHIFT: Day Job
Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s 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.
Duties & Responsibilities
Primary duties may include, but are not limited to:
• Responsible for consulting with providers to improve the effectiveness and efficiencies of provider practices and clinical processes.
• Obtains and analyzes practice specific cost and quality data and reports for cost of care and quality opportunities.
• Helps practice to target high risk Anthem members and gaps in care based on reports provided.
• Supports practice implementation of population health management, care coordination and care management strategies.
• Identifies action plans for providers to implement to improve cost, quality and the patient experience.
• Participates in design, development, and implementation of community learning forums.
• Serves as the point of contact for providers and primary care practices for program on boarding, facilitation of routine meetings between Anthem and the provider office.
• Serves as the subject matter expert and liaison with Anthem Care Management to facilitate clinical processes between the company and the provider office.
• Creates and hosts tailored learning opportunities to support the deployment of program interventions.
• Hosts collaborative learning events that allow practices to learn from one another and national experts, use of the Provider Care Management Solutions (PCMS) tool and other data sources, and provides technical support for the Care Delivery Transformation program within the Enhanced Personal Health Care program (EPHC).
• Collaborates with EPHC team and other program stakeholders, including but not limited to: CDT Market lead, EPHC Provider Solutions team to meet provider and practice service needs.
• Requires a BA/BS and minimum of 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, population health and care management structures, data analytics and electronic health records preferred.
• Clinical background and/or MBA not required but a plus.
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 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. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.
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.