CLINICAL PRACTICE CONSULTANT

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s the foundation upon which we’re creating greater 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. 

 Clinical Practice Consultant
Locations: Seatlle, WA, Dallas, TX, Houston, TX

This work at home position requires approximately 75% local travel to provider offices in assigned (mileage reimbursed).
A day in the life: can you see yourself building relationships with our network physicians? If the answer is yes then this could be the next step in your healthcare career!
  • Educate providers and office staff on HEDIS requirements and clinical documentation/coding as part of office visits and develop working relationships to facilitate care gap closures.
  • During HEDIS season conduct provider medical record reviews and abstract information as part of the data collection process in addition to providing support for over read process related to auditor requirements.
  • Works with QM (Quality Management) and plan leaders to identify opportunities for collaboration with provider offices and facilitates development and follow up of action plans or deliverables.
  • Perform coding audits/analysis on providers.
Holiday Pay is immediate upon employment upcoming dates include: November 27 & 28, December 25 and January 1 & 19.

Job Qualifications

Requirements include:

  • AS/BS in nursing with current unrestricted WA RN or LPN license, BSN/MSN preferred
  • CCS/CPC/RHIT/RHIA strongly preferred
  • 2 years of clinical experience
  • 2 years experience coding or performing coding audits preferred
  • 5 years of managed care experience (includes related experience)
  • 2 years of professional presentations to small and large audiences or any combination of education and experience, which would provide an equivalent background.
  • 2 years HEDIS experience
  • Intermediate skills in Microsoft Word, Excel and PowerPoint required
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 and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran
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