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LCSW or RN Practice Consultant (Employee w/benefits) Remote - San Francisco, Santa Clara, Oakland, California - PS4135 in Los Angeles, CA at Anthem, Inc.

Date Posted: 4/9/2018

Job Snapshot

Job Description

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.

Note: This is not a "consultant" position. This is a FT w/benefits employee position. This Practice Consultant position will focus on working with community based providers within our network. Behavioral health and/or psych. experience is needed for this position. You will be given the training and equipment to work from a home office. You must have a high speed internet connection.

The Practice Consultant is responsible for creating a partnership relationship with providers and other initiatives and implementing the concept of a Medical Home for our members to achieve this fully integrated and accountable system of care.

Primary duties may include, but are not limited to:

Assesses current practice patterns, assets and challenges utilizing Medical Home Index, NCQA Standards, HEDIS audits, site reviews and medical records reviews.

In partnership with the PCP, evaluates results of the initial assessment.

Establishes a project plan with the practice that establishes goals and objectives for improvement.

Provides ongoing practice support and sustains the partnership.

Establishes regular meetings to track progress.

Identifies and facilitates at least one practice in each MPC region to become SSB Physician Champions by obtaining NCQA certification as a Patient Centered Medical Home.

Improves the understanding and sensitivity to the unique needs of this population and the care givers.

Job Requirements

Requires an AS/BS in nursing; 5 years of managed care experience; 2 years of clinical experience; 2 years of experience making professional presentations to small and large audiences; or any combination of education and experience, which would provide an equivalent background.

-Current, unrestricted clinical LCSW or RN license in CA required.

-BSN or MSN preferred.

-Behavioral health and/or psych. experience required.

-Managed care experience preferred.

-Case management experience preferred.

-Experience working with community-based providers preferred.

-Must have excellent verbal and written communication skills.

-Must be able to present information to providers in a professional and influential manner.

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.