Anthem Maternal Child Health Provider Consultant - Virginia PS6035 in Fairfax, Virginia

Maternal Child Health Provider Consultant - Virginia PS6035

New

Location: Norfolk, Virginia, United States

Field: Medical

Requisition #: PS6035

Post Date: 2 days ago

Your 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.

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.

Maternal Child Health Provider Consultant

3 positions available 1 for each location:

Norfolk, VA, Richmond, VA, Northern VA

As a member of the Government Business Division, Maternal Child Services Corporate team the successful candidate will work collaboratively with select Health Plans 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.

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 OB provider practice, identify opportunities for improvement, assess current practice patterns, assets and challenges, NCQA Standards, HEDIS audits, etc.

  • 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 face to face meetings with OB providers 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 outcomes

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 (LVN/LPN, RN, NP, PA, etc.) RN strongly preferred

  • Must be able to travel 50% of the time within the assigned territory. Driving mileage to/from the assigned VA office and the OB provider offices will be reimbursed.

  • 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 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.