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Medical
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PS24403 Requisition #
Your Talent. Our Vision. At Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. companyit’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 healthcare.
 
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 benefits companies and a Fortune Top 50 Company.


Location:  This position is 100% office-based at our new offices in Cary, North Carolina.

 


The Clinical Quality Program Admin is responsible for overseeing the quality improvement activities/projects as outlined in the Quality Improvement (QI) work plan and as required by applicable law, regulations and accreditation standards. 

 

Primary duties may include, but are not limited to:

  • Ensures integration of quality into the overall business process. 
  • Performs assessments to identify gaps in the enterprises quality and technology assessment processes and initiates actions to correct these gaps. 
  • Assures accuracy and completeness of input provided to internal and external QI committees and timely implementation of appropriate interventions. 
  • Oversees the clinical quality improvement activities/projects to implement appropriate clinical interventions to improve the quality of care for members. 
  • Assures compliance with corporate QI work plans. 
  • Assures QI activities are relevant to the targeted population. 
  • Assures compliance to Practice Guideline, Delegation and Continuity and Coordination of care Standards. 
  • Maintains documentation of research programs to meet regulatory and Accreditation Standards.  
  • Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of results.  
  • May provide oversight to the Healthcare Effectiveness Data and Information Set (HEDIS) project team.



  • Requires an active and unrestricted RN license, in the state of North Carolina, or a compact RN license from a reciprocal state.
  • Minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background, is required.
  • Bachelor’s degree in nursing, health administration or related clinical field preferred.
  • Experience in healthcare quality measurements (e.g. HEDIS, NCQA, URAC, regulatory compliance, or data analysis experience) required.
  • Investigating quality of care incidences.
  • Medicaid and/or Managed Care experience preferred
  • Certification in applicable field (i.e. CPHQ) preferred.
  • Experience collaborating with practitioners for quality improvement preferred.
  • Ability to evaluate accreditation standards or regulations.
  • Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint) is required.


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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Supplier Registration Process

Anthem, Inc.'s supplier registration process will automatically enter your information into our prospective supplier database.

Anthem does not do business with persons or entities identified on the General Services Administration's List of Parties Excluded from Federal Programs and the HHS\OIG List of Excluded Individuals\Entities.

Anthem, Inc. Purchase Order Terms

Anthem's standard payment terms are net 50. Payment terms will be calculated from the invoice date, which should also reflect the date goods or services were received.

Anthem also offers various discount options that provide you with the opportunity for early payment and we are also encouraging our suppliers to participate in our electronic funds transfer (EFT) method of payment. The EFT method of payment will improve the efficiency of our payment processes and ensure that you are paid properly and on time.

Anthem, Inc. Supplier Registration Process

*Please Note: To complete the supplier registration process, you will leave antheminc.com and will be directed to the Ariba Network (AN) site. Once there please click on Register as New Supplier to complete the online registration form and follow the on-screen instructions.

Supplier Registration

Anthem, Inc. utilizes the Ariba Network to determine qualified suppliers that meet Anthem’s business need. Prospective suppliers should complete Ariba’s Supplier Registration Process.*

*Please Note: To complete the supplier registration process, you will leave antheminc.com and enter the Ariba Network (AN) site. Once there, please click on 'Register as New Supplier' on the left-hand side of the screen, complete the online registration form and follow the on-screen instructions.

Anthem does not do business with persons or entities identified on the General Services Administration's List of Parties Excluded from Federal Programs and the HHS\OIG List of Excluded Individuals\Entities.

What to expect next after registration

Anthem Inc.'s Procurement department will review your registration and additional materials. If our sourcing needs align with your goods or services, an Anthem Buyer will contact you to discuss next steps and other pertinent details. If there is no current need, your information will remain in our prospective supplier database for one year for processing against future requests.

Supporting Documents

Guidelines for Prospective Suppliers (PDF)

Company Policy and Procedures (PDF)

To obtain a copy of Anthem's Supplier Travel Guidelines, please send an email to TravelPoint@anthem.com.