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Job Summary

Company
Anthem
Location
Overland Park, KS
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS4162

Patient Centered Care Consultant (Job Family) - Overland Park, KS - PS4162

About the Job

Description

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 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.

Please Note: This position may be filled at the Patient Centered Care Consultant, Patient Centered Care Consultant Sr., or the Care Consultant Sr. level. Manager will determine level based upon the selected applicant's skillset relative to the qualifications listed for this position.

Patient Centered Care Consultant / Consultant Sr. / or Care Consultant Sr. (Job Family) - Overland Park, KS

The Patient Centered Care Consultant is responsible for providing support to providers to improve the quality and effectiveness and efficiencies of provider practices participating in our alternative payment programs. Primary duties may include, but are not limited to:

  • Obtains and analyzes quality metrics and reports for care opportunities, supports practice implementation of care coordination and care management, identifies action plans for providers to implement to improve cost, quality and the patient experience and participates in design, development, and implementation of community learning forums.
  • Collaborates with Care Delivery Transformation team including but not limited to: engagement manager, clinical liaison, provider contractors and network relations reps to meet provider and practice service needs.
  • Actively participates in developing program recommendations and action plans.
  • Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients.
  • Promotes practice transformation to team based patient centered care delivery.
  • Provides education for practices to develop expertise with metrics and data review for quality improvement.
  • May participate in various community and multi-department committees to assure effective program implementation.
  • Tracks progress of program and prepares status reports to management or senior management.
  • Maintains up to date knowledge on Patient Centered medical Home, Care Delivery System Redesign and Accountable Care Organizations.

The Patient Centered Care Consultant Sr. serves as a team lead responsible for consulting with providers to improve the effectiveness and efficiencies of provider practices. Primary duties may include, but are not limited to:

  • Obtains and analyzes quality metrics and reports for care opportunities, supports practice implementation of care coordination and care management, identifies action plans for providers to implement to improve cost, quality and the patient experience and participates in design, development, and implementation of community learning forums.
  • Collaborates with Patient Centered Primary Care team including but not limited to: engagement manager, clinical liaison, provider contractors and network relations reps to meet provider and practice service needs.
  • Actively participates or leads in developing program recommendations and action plans (Internal).
  • Makes recommendations to providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients.
  • Promotes practice transformation to team based patient centered care delivery.
  • Provides education for practices to develop expertise with metrics and data review for quality improvement.
  • Actively participates in various community and multi-department committees to assure effective program implementation.
  • Tracks progress of program and prepares status reports to management or senior management. Maintains up to date knowledge on Patient Centered medical Home, Care Delivery System Redesign and Accountable Care Organizations.

The Care Consultant Senior is responsible for consulting with providers to improve the effectiveness and efficiencies of provider practices and clinical processes. Primary duties may include, but are not limited to:

  • Obtains and analyzes practice specific cost and quality data and reports for cost of care and quality opportunities, helps practice to identify, document, and implement action plans for providers to improve cost, quality and the patient experience.
  • Target high risk Anthem members and gaps in care based on reports provided, supports practice implementation of population health management, care coordination and care management strategies, and participates in design, development, and implementation of community learning forums.
  • Serves as the point of contact for providers and primary care practices for program on boarding, facilitation of routine meetings between Anthem and the provider office(s).
  • Serves as the subject matter expert and liaison with Anthem Care Management to facilitate clinical processes between the company and the provider office.
  • Creates and hosts tailored learning opportunities to support the deployment of program interventions.
  • Hosts collaborative learning events which allow practices to learn from one another and national experts.
  • Use of the Population Management platform tool and other data sources, and provides technical support for the Medicaid Care Delivery Transformation program.
  • Collaborates with national CDT team and other program stakeholders, including but not limited to: CDT Manager, Care Consultant Principle, and local Provider Solutions team to meet provider and practice service needs.

Qualifications

Patient Centered Care Consultant - Qualifications:

  • Requires a BA/BS; 3 years health care experience; or any combination of education and experience, which would provide an equivalent background.
  • Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, and electronic health records preferred.
  • Travel required within the assigned territory up to 50% to 75%+ of time.
  • Strong knowledge and proficiency with Microsoft Excel and PowerPoint required.

Patient Centered Care Consultant Sr. - Qualifications:

  • Requires a BA/BS; 5 years health care experience; or any combination of education and experience, which would provide an equivalent background.
  • Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, and electronic health records preferred.
  • Travel required within the assigned territory up to 50% to 75%+ of time.
  • Strong knowledge and proficiency with Microsoft Excel and PowerPoint required.

Care Consultant Senior - Qualifications:

  • Requires a BA/BS; 5-10 years health care experience; or any combination of education and experience, which would provide an equivalent background.
  • Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, population health and care management structures, data analytics and electronic health records preferred.
  • Clinical background and/or MBA not required but a plus.
  • Travel required within the assigned territory up to 50% to 75%+ of time.
  • Strong knowledge and proficiency with Microsoft 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 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.

 

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