Clinical Quality Auditor Lead
Company: Anthem, Inc.
Posted on: May 3, 2021
SHIFT: Day Job
Your Talent. Our Vision. At CareMore, a proud member of the
Anthem, Inc. family of companies, it's a powerful combination. It's
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
CareMore is a proven care delivery model for the highest-risk.
We are a team of committed clinicians and business leaders
passionate about transforming American healthcare delivery. We
build and lead integrated, multi-disciplinary clinical teams to
care for the most complex patients. We strive for excellence and
have achieved significant and measurable improvement in total cost
of care, clinical outcomes, and experience. As an Anthem
subsidiary, we benefit from the scale and resources one of
America's largest managed healthcare organizations.
The CareMore Clinical Quality Auditor is responsible for
performing Quality Management (QM) functions of the Health Care
Services Department and ensuring QM compliance with health plan and
regulatory standards. Primary duties may include, but are not
- Serves as a resource to the plan and providers for QM
- Prepares, reviews, and analyzes daily/weekly/monthly reports
that are maintained for statistical or regulatory purposes.
- Monitors referral process and identifies opportunities for
- Assists with audits and surveys.
- Monitors maintain and enhances Chronic Care Improvement
Programs (CCIPs) and Quality Improvement Projects (QIPs).
- Completes medical record reviews and other related
- a high school diploma; 3 years of related experience; or any
combination of education and experience, which would provide an
- Current LPN, LVN, or RN license in applicable state(s)
- BS or MBA in Nursing preferred.
We offer a range of market-competitive total rewards that
include merit increases, paid holidays, Paid Time Off, and
incentive bonus programs (unless covered by a collective bargaining
agreement), medical, dental, vision, short and long term disability
benefits, 401(k) +match, stock purchase plan, life insurance,
wellness programs, and financial education resources, to name a
Anthem, 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. Anthem promotes the delivery of
services in a culturally competent manner and considers cultural
competency when evaluating applicants for all Anthem positions.
Keywords: Anthem, Inc., Austin , Clinical Quality Auditor Lead, Other , Austin, Texas
Didn't find what you're looking for? Search again!