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Anthem, Inc. Clinical Process Improvement Consultant in Hingham, Massachusetts

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, 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.

For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Location: Remote based in the Greater New England/Northeast region

The Process Improvement Consultant position will be responsible for generating process improvements that bring about measurable improvement in quality and/or efficiency. This position will contribute to achieve department's objectives by serving as key contact for researching and implementing solutions and tools for new systems and other key operational improvements, provide guidance to leads, operations experts, associates, and/or managers on process improvement issues.

What does a typical day look like?

Primary duties may include, but are not limited to:

  • Represents the department on process improvement teams, special projects and implementation of new technology.

  • Lead role in coordinating annual review/revision of procedures.

  • Leads the training of associates when new processes or procedures are implemented.

  • Communicates process information and facilitates workgroups to ensure accurate and consistent workload reporting.

  • Review /analyze monthly workload reports to ensure goals are on-target (timeliness, backlog) across all operational sites.

  • Identify areas of concern & implement corrective plans if necessary.

  • Uses reports and production statistics to represent unit(s) in departmental process improvement and system changes and provides specialized input on reports to management.

Qualifications

What You Contribute:

  • Requires a BA/BS degree in a related field, 5-8 years of related experience; or any combination of education and experience, which would provide an equivalent background.

  • RN, Certified Project Manager or Certified Professional Coder preferred.

  • Previous experience in high-volume operations (Medical Review, Appeals, Claims, Customer Service) required.

  • Demonstrate ability to analyze existing and potential workflows, processes, supporting systems, and procedures and identifying improvements required.

  • Excellent oral, written and interpersonal communication skills required.

  • Strong analytical, organizational, planning, problem solving and project/decision facilitation skills required.

  • Ability to travel maybe required.

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. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.

REQNUMBER: PS45757

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