Anthem, Inc. Hiring for Quality Evaluator (RN, LCSW, RT) at Savannah, Georgia Full Time

Description

SHIFT: Day Job

SCHEDULE: Full-time

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 care companies and a Fortune Top 50 Company.

We are hiring a Quality Evaluator. Responsible to monitor and evaluate clinical contact between program staff and participants, assessing adherence to protocols and appropriate clinical interaction. Evaluates calls for these major areas: safety, clinical effectiveness, productivity and customer service.

Primary duties may include, but are not limited to:

• Provides written and/or verbal feedback to program staff to assist with performance improvement and staff development.

• Develops reporting and overall performance trend identification.

• Ensures each associate meets standard performance criteria and ensures associates are moving program participants toward desired levels of engagement or enrollment, program retention and positive clinical outcomes (i.e. improved health).

  Analyzes individual and overall trends based on monitoring results and providing recommendations to operations management or learning

  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 few.

  Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.

Qualifications

Qualifications – External

• Requires a BS/BA in nursing, social work, respiratory therapy or related clinical field; 3 years of experience in managed care to include experience in case management, clinical staff development or education, clinical quality; or any combination of education and experience, which would provide an equivalent background.

• Current unrestricted license in applicable state(s) for designated field (i.e. RN, Social Work, Respiratory Therapy) required.

• Clinically relevant certification (i.e. Certified Case Manager) and a background in quality or performance improvement preferred.

  REQNUMBER: PS56546-Georgia