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Director Clinical Programs - PS19620

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Medical
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PS19620 Requisition #
Thanks for your interest in the Director Clinical Programs - PS19620 position. Unfortunately this position has been closed but you can search our 1,193 open jobs by clicking here.
  • Requires a BS in nursing or a physician’s assistant credential.
  • 6 years of experience in a health care environment, health education program planning or social service including 2 years of managed care experience.
  • 2 years of management experience.
  • 2 years of experience directing, implementing, and managing large projects.
  • Any combination of education and experience, which would provide an equivalent background.
  • Nurse or physician assistant experience required.
  • Experience in public speaking at conferences and other public venues required.
  • Certified coding specialist (CCS); certified documentation improvement practitioner (CDIP) preferred.
  • Knowledge of auditing, a working knowledge of CPT/HCPCS and ICD 9 and ICD 10 preferred.
  • Working Knowledge of DRG Validation preferred.
  • Medical claims review with prior health care audit experience preferred. 
  • Previous experience in HIM and/or provider audit or Clinical Documentation Improvement preferred.
  • Dietetic certification and course completion/certification in America's Health Insurance Plans Executive Program or similar program preferred.
  • MS in public health, health education, public policy, health administration or a related field required.
  • PhD in public health, health education, public policy, health administration or a related field preferred.

 

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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Metrics & Data

Leverage your talents to make a difference in people's lives, by providing innovative, data-driven solutions that can measure and improve consumer's health.

Anthem metrics and data associates focus on creating innovative, data-driven solutions that can measure and track progress in our members’ health. Collaborate with internal and external experts to develop metrics-supported strategies for improving measurements and processes.

Enable physicians and hospitals to improve care with valuable information that improves care quality and affordability. Join us and help provide tools to help consumers make better decisions, as we create a simpler, more affordable, more accesible healthcare system.

Metrics and data associates at Anthem:

  • Develop statistical models and functional means for measuring the quality of health care members receive annually
  • Provide members with useful, powerful tools for self-evaluation and tracking of health issues and risk factors
  • Show initiative and make key decisions with the potential to dramatically influence patient outcomes and positively impact peoples' lives
  • Create thoughtful solutions that engage and empower members to make more informed decisions about their health and health care
  • Serve as a catalyst to improve the essential relationship between patient and health care provider
  • Leverage metrics and data to deliver resources that help overcome traditional coverage barriers such as education, literacy and language

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