Your Talent. Our Vision. At Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. company, 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.
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.
Practice Consultant, North Carolina
Winston-Salem & Durham
As a member of the Government Business Division, Maternal Child Services Corporate team the successful candidate will work collaboratively with select Health Plans in the East and/or South region of the United States to improve Obstetrics provider collaboration and quality member outcomes. Additionally, in collaboration with health plan Quality, Provider Relations and Provider Network development teams, the successful candidate will work closely with group and individual provider offices to provide information on Maternal Child Services programs, share provider profile (score card) results and Obstetrics Provider-Quality Improvement Program (OBQIP) reports.
Maternal Child Health Practice Consultant North Carolina
Responsible for creating and implementing quality provider and member initiatives within assigned markets. Through establishing a collaborative partnership with providers, quality initiatives will focus on driving performance guarantee outcomes and NCQA accreditation.
Primary duties may include, but are not limited to:
Assesses quality performance of the primary care practice, identify opportunities for improvement, asses current practice patterns, assets and challenges, NCQA Standards, HEDIS audits, medical records reviews and site reviews.
In partnership with the OB, evaluates quality opportunities for implementation by establishing a project plan with the practice that identifies goals and objectives for improvement
Provides ongoing practice support and sustains the partnership
Establishes regular meetings to track progress.
Improves the understanding and sensitivity to the unique needs of this population and the care givers
Successful candidate will be adept at data interpretation with ability to develop and implement a quality plan to achieved
Requires an AS/BS in nursing; Bachelors in nursing (BSN) strongly preferred. 5 years of managed care experience; 2 years of clinical experience; 2 years of professional presentations to small and large audiences; or any combination of education and experience, which would provide an equivalent background.
Current, unrestricted clinical license appropriate to field of specialty in the state of North Carolina (LVN/LPN, RN, NP, PA, etc.) RN strongly preferred
Must be able to travel 50% of the time within the assigned territory
Seeking energetic, self-directed candidates with an outgoing personality and great communication and presentation skills
Experience with provider operations preferred
Experience with maternal and child health required
HEDIS experience also 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.