Anthem Performance Quality Analyst III - Any Anthem Office Location - 128144 in Andover, Massachusetts
/ 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.
Performance Quality Analyst III - 128144
Work Location: Any Anthem office location.
This position is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise.
Primary duties may include, but are not limited to:
- Acts as auditor in charge for audits and special projects, writing Standard Operating Procedure’s (SOPs) for any new initiative or project, creating and delivering training materials for any new or changing systems and applications within Sales Compensation, Licensing and Credentialing (SCLC) team.
- Translates business need into appropriate, comprehensive quality validation strategies and design.
- Participates in pre and post implementation audits of production team transactions.
- Audits multiple lines of business, multiple functions, and multiple systems.
- Trend audit results and perform data analysis on trends to determine/recommend adjustments to quality reviews, develops and recommends process improvements and solutions.
- Functions as a subject matter expert for discrepancy review, questions from team and business partners, and interpretation of guidelines and audit process.
- Facilitate and lead meetings with business to review audit plan, audit findings and/or recommendations for improvement.
- Acts as a mentor to peer auditors, providing training and managing work and projects as necessary.
Facilitate calibration sessions with the business area, support areas, vendors or clients.
Requires a BS/BA
- 5 years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 2 years’ experience on a Sales Compensation, Licensing and Credentialing (SCLC) production team ; or any combination of education and experience, which would provide an equivalent background.
- Audit experience preferred.
- Strong analytical skills highly preferred.
/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./
Title: Performance Quality Analyst III - Any Anthem Office Location - 128144
Requisition ID: 128144