Director Quality Management

Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it’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 health care.We are hiring for a Director Quality Management. 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 care companies and a Fortune Top 50 Company.Responsible for driving the development, coordination, communication, and implementation of a strategic clinical quality management and improvement program within assigned health plan. Primary duties may include, but are not limited to: Directs and provides leadership for implementing, monitoring and evaluating the Quality Management Program for the health plan Promotes understanding, communication, and coordination of the quality management programCollaborate with Quality Management Leadership for compliance with National Committee for Quality Assurance (NCQA) standardsProvides leadership for the interpretation of results and development of improvement action plans arising from provider and member satisfaction surveysServes as a resource for the design and evaluation of process improvement plans/quality improvement plans and ensures they meet Continuous Quality Improvement (CQI) methodology and state contractual requirementsCollaborates with other leaders in developing, monitoring, and evaluating Healthcare Effectiveness Data Information Set (HEDIS) improvement action plans, year round medical record review, and over read processesMonitors and reports quality measures per state, Centers for Medicare and Medicaid Services (CMS), and accrediting requirementsHires, trains, coaches, counsels, and evaluates performance of direct reports Qualifications Requires a BA/BS in a health or business related field8 years of experience in a healthcare environment, including prior leadership in quality management; or any combination of education and experience, which would provide an equivalent background MSN, MPH, or MPA preferred. Current clinical license preferred. CQM experience in a Managed Care Organization preferredAnthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.REQNUMBER: PS40853-US