* Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions. *
* Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine. *
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Process Improvement Manager Sr. Clinician Preferred - Nationwide (Telecommute) *
The Process Improvement and Enhancement ( PIE ) Team is responsible for communicating Medicaid and Medicare Clinical and Non-Clinical auditing results across multiple systems. This particular role is responsible for working with assigned UM health plans to review audit results, develop action plans for improvement and to partner with them to ensure improved audit scores, as well as focused audits as assigned. The incumbent is also responsible for conducting focused audits including documenting results from audits in Excel and working with our reporting team to analyze and develop reports summarizing the results that will be shared with management . The focused audits will be managed using MS Project; therefore , familiarity with developing sequenced steps of project planning in this application is a plus. Familiarity with Utilization Management processes and use of NCQA guidelines and criteria preferred. Experience navigating in Verint software a plus.
Primary duties may include, but are not limited to:
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* Documenting milestones and key tasks to complete a project
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* Collaborates with cross-functional teams in the identification, research and implementation of process improvements. .
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* Managing multiple large project plans or action plans for improvement and reporting statuses within each of the plans.
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* Manages internal and external process improvement projects with team members who work across regional and enterprise wide organizational structures and with external parties (providers and trade organizations) to formulate consensus on improvements and to implement internal and external systems, policies and procedures.
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*/ Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /*
* Requires *
BA/BS in a related field,
Requires a BA/BS degree in a related field,
8-10 years of process improvement experience with planning, project management, business analysis, and leadership role experience;
or any combination of education and experience
3 years of experience as a Process Improvement Manager level;
Experience with Microsoft Office (Word, Excel, Outlook, Project, PowerPoint)
Experience with utilization management
Six Sigma Black Belt certification preferred.
Experience working with SharePoint and Facets preferred
**Job** *Business Support*
**Title:** *Process Improvement Manager Sr. Clinician - Telecommute (119714 KT)*
**Location:** *CA-Rancho Cordova*
**Requisition ID:** *119714*