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Staff VP Accreditation & Prog

Chicago, IL, USA | Anthem

  • Industry:
    Insurance - Health & Life
  • Position Type:
  • Functions:
    Regulatory Affairs
  • Experience:
    7-10 years
Job Description:
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Responsible for acquiring, maintaining, and maximizing clinical accreditation across all Anthem lines of business and applicable entities. Works with business leaders and stakeholders to meet or exceed accreditation standards, and to address opportunities for improvement across standards as well as Consumer Assessment of Healthcare Providers and Systems (CAHPS) outcomes.


Primary duties may include, but are not limited to:

Responsible for health plan accreditation and specialty accreditations including Managed Behavioral Health Care, Multicultural Health Care, and accreditation for subsidiaries including IngenioRx.

Also responsible for leading the enterprise CAHPS improvement strategy by working cross-functionally to identify emerging trends and innovative solutions to address gaps in CAHPS performance.

Develops and executes comprehensive strategy to maximize all accreditation efforts, improve CAHPS scores, and to improve Commercial NCQA Accreditation status, NCQA Star Ratings and Exchange Quality Counts Quality Rating System (QRS) Ratings.

Develops and executes multi-cultural health efforts.

Hires, trains, coaches, counsels and evaluates performance of direct reports.

Requires a BA/BS degree in related field.

8 years of management experience with significant large scale project management, strategic planning, and/or consulting in a health care industry; experience leading large scale accreditation efforts across multiple lines of business; process improvement such as Six Sigma, TQM or other quality background.

Any combination of education and experience, which would provide an equivalent background.

Accreditation background - knowledge and familiarity with CAHPS.

MA/MS/MBA degree preferred.

NCQA Surveyor experience preferred.

Travel may be required (10% - 20%).

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