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Anthem, Inc. HEDIS Practice Consultant - Medicare Central - REMOTE in Wisconsin in Waukesha, Wisconsin

HEDIS Practice Consultant - Medicare Central - REMOTE in Wisconsin

Location: Wisconsin, United States

Requisition #: PS30985

Post Date: Jan 03, 2020

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.

Preferred Location : Wisconsin

This is a work from home position, must have high speed internet and have computer and Microsoft Office proficiency.

The Practice Consultant is responsible for creating a partnership relationship with providers to improve HEDIS scores and reporting of HEDIS and other quality initiatives for our members to achieve this fully integrated and accountable system of care. Primary duties may include, but are not limited to:

  • Assesses current practice patterns, assets and challenges utilizing Medical Home

  • Index, NCQA Standards, HEDIS audits and medical records reviews.

  • In partnership with the PCP, may evaluate results of the initial assessment.

  • Establishes a project plan with the practice that establishes goals and objectives for improvement.

  • Provides ongoing practice support and sustains the partnership.

  • Establishes regular meetings to track progress.

  • Ongoing medical record reviews and abstractions.

  • Improves the understanding and sensitivity to the unique needs of this population and the care givers.


  • AS/BS in nursing or similar field; a minimum of 2-3+ years of HEDIS experience; 2 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.

  • You must in Wisconsin.

  • Current, unrestricted clinical license (LVN/LPN, RN, NP, or PA) in the state in where you reside is required

  • BSN or MSN preferred.

  • Medical record review experience required.

  • Managed care and/or Medicare experience preferred.

  • May require occasional local travel.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.