Quality Improvement Admin - 32452

WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.

Responsible for developing and implementing quality programs to assess health care professionals and monitor compliance and accreditation standards. Primary duties may include, but are not limited to: Develops, implements, and analyzes existing processes relating to on-site review of physician offices. Develops standard assessment and documentation tools to ensure compliance with accreditation standards. Manages activities involving participating healthcare professionals to ensure that Anthem's members receive quality care through formal physician presentations, partnering with network management, marketing, and other areas. Assists with the regional HP/DSM's in the development of guidelines and programs and interventions and collecting data for clinical quality improvement projects. Requires current unrestricted RN license in applicable state(s) and 3 - 5 years clinical experience as well as managed care or clinical quality improvement experience or any combination of education and experience, which would provide an equivalent background. BSN preferred. Knowledge of NCQA, state and federal regulations, knowledge of health care delivery system, and knowledge of QA and continuous quality improvement principles. Ability to travel required.