Staff VP Leader Clinical Quality Management 96414

Company Name:
Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.
Responsible for leading Corporate Clinical Quality for the Commercial line of business, nationwide. Responsible for developing, implementing and leading strategy to ensure oversight of corporate and health plan clinical quality management services across all markets. Primary duties may include, but are not limited to:
Responsible for implementing collaborative line of business member and provider strategies focusing on improving quality scores that result in increased revenues and growth.
Monitors clinical quality measures and trends and formulates strategies with business partners to improve clinical outcomes and reduce/manage costs.
Develops, reviews and evaluates Quality Management program at the corporate and health plan level.
Accountable for maintaining compliance and accreditation as appropriate.
Provides guidance to line of business leadership in clinical trends and development opportunities.
Provides oversight in the planning, implementation and coordination of health care audits and participates in quality review activities.
Manages and oversees quality assurance activities, identifies and integrates best practices into health plan programs.
Serves as the subject matter expert on clinical quality management, program development, measurement criteria, and maintains awareness of industry standards and trends.
Participates on quality committees and work streams.
Hires, trains, coaches, counsels, and evaluates performance of direct reports. Requires a BA/BS degree; 10 years of experience in quality management, quality improvement, risk management and/or utilization management in a managed care organization; 7 years leadership/management experience; prior experience in health care quality measurement and reporting; or any combination of education and experience, which would provide an equivalent background. MPH, MBA or PhD preferred. RN preferred. Experience with member and provider program development for Medicaid, Medicare, Commercial and National business preferred.
/Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at/ / / /. EOE.M/F/Disability/Veteran./
Job Medical
Title: Staff VP Leader Clinical Quality Management 96414
Location: AZ-Scottsdate
Other Locations: VA-Virginia Beach
Requisition ID: 96414

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