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Manager II GBD Quality Management- Plan HEDIS/Health Promotions Atlanta, GA PS11700

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Medical
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PS11700 Requisition #
Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies, it’s a power combination.  We are focused on serving Medicaid, Medicare and uninsured individuals it’s the foundation upon which we’re creating greater 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. 

Manager II GBD Quality Management- Plan HEDIS/Health Promotions  Atlanta, GA PS11700

Work Location: Atlanta, GA

Responsible for developing and ensuring effective coordination of quality initiatives within the health plan, to include indicators for monitoring and evaluating the quality of care, service, and satisfaction of providers and members. 

Primary duties may include, but are not limited to: 
• Establishes Quality Management and Health Promotion objectives and annual goals. 
• Develops and submits dashboard reports for all state, Centers for Medicare and Medicaid Services (CMS), and accrediting measures; analyzes validity of quality management data/reports from a clinical perspective. 
• Coordinates development, implementation, and evaluation of quality improvement action plans. 
• Provides oversight and ensures implementation of the Healthcare Effectiveness Data Information Set (HEDIS) data management and reporting strategy; coordinates the related improvement action plans. 
• Provides training and education to meet National Committee for Quality Assurance (NCQA) standards. 
• Manage external practice facing relationships and internal relationships with Provider Solutions  leadership, Medical Directors and Health Care Delivery Systems (HCDS) leadership. 
• Ensures appropriate program tracking and performance reporting data for respective markets. 
• Develop and  deploy tools, resources and documentation to support Health Promotion/Quality Management programs and the tracking/reporting of the program successes.
• Provides primary oversight and direction of the Health Promotion Consultants in their assigned regions of Georgia.  (Some travel required within the state)
• Hires, trains, coaches, counsels and evaluates performance of direct reports.
• Requires a BA/BS in a health or business related field; 7 years of experience in a healthcare environment, including prior management experience; or any combination of education and experience, which would provide an equivalent background. 
• 5+ years leadership/management strongly preferred.
• Requires HEDIS knowledge and experience. 5+ years HEDIS experience preferred.
• Must have excellent communication skills (written and verbal), interpersonal skills, project management and organizational skills.
• Requires exceptional networking & negotiations skills, and strong public speaking/presentation skill, and previous consumer marketing and/or grassroots/community outreach experience
• Proficient MS Word, Excel, Outlook, and PowerPoint.

Preferred:
• RN or LPN 
• Certified Professional Coder (CPC), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT)
• Lean Six Sigma Training (Green Belt or Black Belt)
• Certified Professional in Healthcare Quality (CPHQ)
• Population health management and/or clinical quality program development experience preferred.
• Experience working with HEDIS, EPSDT, medical record audit or review.
• HEDIS project management experience
• Experience with Quality Improvement and Corrective Action plans.
• Experience working in a health insurance company or Medicaid, Managed Care setting.
• Experience with Inovalon software - QSHR 
• Strong strategic thinking and analytical skills; excellent organizational, presentation, and problem solving skills.        
• Candidate must be task and project-oriented with an excellent sense of priority, logic and objectivity. 
• Seeks out opportunities for process improvements/efficiencies, and supports business initiatives.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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Our associates are the heart of who we are. Every day, they work to make health care simpler, more accessible, and more affordable for the diverse communities we serve. We like to say at Anthem that every person counts and all perspectives matter. We work every day to make that a reality by fostering an inclusive culture – based on mutual respect and genuine appreciation.

We believe that our differences and similarities combined with a common purpose are the pillars of a rich and cohesive network of individuals who infuse new thinking, deeper insight, and broader perspectives to everything we do.

This makes us stronger as an organization and a great place for associates to collaborate, develop, and grow while improving the lives of the consumers, care providers and communities we serve.

– Tracy Edmonds

VP Diversity & Inclusion and Chief Diversity Officer

Be Part of an Inclusive Culture

Workforce Diversity

At Anthem Inc., we believe that having a diverse workforce is critical to innovation and to addressing the needs of the diverse customers and communities we serve. Women make up 76% of our workforce and 63% of all management roles. People of color represent 43% of our workforce and 29% of management. More about the breakout of our workforce in Anthem Corporate Responsibility.

Workforce Recruitment

Our commitment to improving access to affordable care while simplifying the health care experience for consumers requires the best talent, passion, broad insight and experience, and an innovative mindset.

We partner with external organizations, colleges and universities, and our nine associate resource groups to recruit, retain, and develop a workforce that reflects the communities we serve -- and to implement best practices to offer an inclusive environment for all. Our partnerships include: UNCF, United States Business Leadership Network (USBLN); National Association on Disability (NOD), Amerigroup National Advisory Board; Easter Seals; Job Accommodation Network (JAN); MindShift; VeteranRecruiting; HirePurpose; Hiring Our Heroes; Military Spouse Corporate Career Network; Out & Equal; Hispanic Association on Corporate Responsibility (HACR); Diversity Best Practices, among many others.

Associate Resource Groups

Our nine Associate Resource Groups (ARGs) include associates from all areas of the organization, multiple locations and a wide-range of experiences and backgrounds. The groups encourage diversity of perspectives and insight and help put the passion of our associates into action in order to make a real difference for our consumers and the communities we serve. Our ARGs help tackle business issues, participate in community programs, and facilitate opportunities for education, development, and networking. ARGs are open to all Anthem associates.

  • ABLE: Disability Inclusion Network Abilities Beyond Limited Expectations
  • ACE Asians Committed to Excellence
  • APEX African American Professional Exchange
  • HYPE Healthcare Your Professional Exchange
  • PRIDE Promoting Respect, Individuality, Diversity and Equality
  • SOMOS Hispanic ARG
  • VOA Veterans of Anthem
  • W@VE Working @ Anthem in a Virtual Environment
  • WIN Women’s Inspired Network

LGBTQ inclusion – SAFE Space and Gender Transition Guidelines

We are proud to be recognized by the HRC among the Best Places to Work for LGBTQ Equality by obtaining a perfect score in the Corporate Equality Index. Our PRIDE ARG helps us identify and implement best practices and programs such as the Anthem Safe Space Program, the Gender Inclusion and Transition Guidelines, and Transgender Training for customer-facing associates. This ARG also helped create “Building an LGBT –Friendly Practice”, an online training module that we offer to all health care providers.

People with Disabilities

We have a strong commitment to the employment of people with disabilities and partner closely with external organizations and our ABLE ARG to nurture a culture and a physical environment that are both inclusive of associates as well as customers with disabilities. We have received the Leading Disability Employer Seal by NOD (2016-2017), a perfect score in the USBLN’s Disability Equality Index since 2016 and the Portlight “Getting It Right” Award in 2017 for our work in disaster preparedness and recovery for people with disabilities.

Veterans

It's important to us to offer our veterans opportunities to take their career in a new direction because we believe their spirit of service is essential to improving health care. Our VOA ARG partners with Talent Acquisition to maximize our ability to attract and retain veterans and their family members. The group also focuses on supporting our troops by sending care packages during the holidays and participating in events year-round. Learn more in our veterans’ page.

Unconscious Bias training

We train our leaders to make more informed and effective decisions by mitigating unconscious bias. There’s extensive research about the impact of unintended bias in decisions that affect people in the workplace so in 2017 we launched “Decide: The Neuroscience of Breaking Bias,” an eLearning experience that helps leaders identify, label and take action to minimize bias in order to build effective and inclusive teams.

Connect With Our Communities

Our associates are passionate about serving our members and giving back to the community and the company supports these efforts through several programs.

Year-round, Anthem associates give generously to health-related nonprofit organizations across the country through our Associate Giving Program, which offers a 50 percent match from the Anthem Foundation.

The Dollars for Doers program encourages year-round associate volunteerism—and helps associates’ commitment go even further by providing grants to eligible organizations where the volunteer service is completed. In 2017, our associates logged over 55,000 hours! To make it even easier to volunteer, associates can have up to eight hours of paid volunteer time off each year to be used to volunteer at qualified charities of their choice.

The Volunteer Recognition Program invites Anthem associates to share their volunteer stories or nominate their colleagues who volunteer in the community. Each quarter associates nominate and vote for a winner who exemplifies our value of Caring for Our Communities. The winner chooses an eligible charity to receive a special grant from the Anthem Foundation.

Learn more about how Anthem associates give back to their communities.

 
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