Anthem Clinical Program Development Manager (NY HARP Program) Pine St., NYC - PS11389 in New York City, New York

Clinical Program Development Manager (NY HARP Program) Pine St., NYC - PS11389


Location: New York City, New York, United States

Field: Medical

Requisition #: PS11389

Post Date: Aug 23, 2018

Your Talent. Our Vision. At Empire Blue Cross Blue Shield , a proud member of the Anthem, Inc. family of companies, 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.

This is a high level, individual contributor role. The Clinical Program Development Manager is responsible for managing clinical program development for population-based clinical quality measures including HEDIS within a clinical area and across all lines of business.

This position, based in the NY Health Plan office at 9 Pine St., NYC, will focus on Medicaid behavioral health, Health Homes services and the NY HARP program. You will be the liaison with the State and represent the NY health plan at state meetings in Albany. Knowledge of NY state regulatory policy is highly preferred.

Primary duties to include, but are not limited to:

-Evaluates industry best practices, medical research and other resources to develop clinical programs and tools which facilitate and support quality, cost-effective care.

-Develops and implements an annual plan detailing the strategies, programs and tools to be implemented. Leads program development activities.

-Develops and coordinates presentations, communications and implementation for all phases of the clinical programs/tools development and implementation.

-Ensures all programs and tools are compliant with regulatory directives and state/federal laws and policies.

-Identifies system needs to implement clinical programs.

-Develops system requirements and ROI.

-Tracks program performance and results and modifies as needed.

-Provides leadership and guidance to associates involved in program development and implementation activities.

Requires a BA in business, public health, nursing, epidemiology biostatistics, or related field; 5 years of experience involving analyses of health care data and clinical program development; or any combination of education and experience, which would provide an equivalent background.

-MS in public health, health services administration, nursing, or business administration preferred.

-Clinical license a plus.

-Knowledge of NY HARP and NY state regulatory regulations needed.

-Medicaid/managed care experience preferred.

-Able to review reports containing large amounts of data to analyze trends and identify areas for improvement.

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