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Quality Improvement Specialist...


Job Summary

Alameda, CA
Other/Not Classified
Job Type
Full Time
Career Level
Experienced (Non-Manager)
Job Reference Code

Quality Improvement Specialist - Remote in Alameda County preferred or San Francisco Bay Area, CA

About the Job

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.

Quality Improvement Specialist - Remote in Alameda County preferred or San Francisco Bay Area, CA

The Quality Improvement Specialist will have the primary responsibility of coordinating key quality improvement (QI) activities and projects at a number of provider practice sites. The ideal candidate will work with all levels of physician practice staff to educate on clinical quality measure specifically as it relates to HEDIS, and facilitate process improvement activities to improve quality of care. Primary duties may include, but are not limited to:

  • Focuses on identifying, recommending and implementing a standardized approach to performing and scoring quality audits.
  • Examines and evaluates the accuracy of transactions processed by reviewing policy, procedure and manual input in accordance with guidelines.
  • Tracks, trends and reports audit results to management.
  • Identifies and communicates training issues and assists in developing corrective action plans.
  • Runs and monitors monthly reports from database to identify and/or correct any incorrect data.
  • Local travel at least 50% required.


  • Requires a High School diploma or GED
  • 5 years of experience in health care, medical terminology and coding, 2-3 years of related experience; or any combination of education and experience, which would provide an equivalent background.

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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