Denver, Colorado


SHIFT: Day Job

SCHEDULE: Full-time

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 care companies and a Fortune Top 50 Company.


* This position may primarily work at home (virtual) and requires travel to local provider offices weekly (post-COVID environment).

Responsible for serving as a dedicated provider engagement consultant, managing CMS Stars Quality programs and Medicare Risk Adjustment documentation and coding accuracy initiatives within the Medicare Advantage line of business. Primary responsibilities may include, but are not limited to:

  • Facilitates monthly IPA, MSO and group level Quality (HEDIS/CAHPS/HOS) and Medicare Risk Adjustment strategy meetings. Develops an Action Plan, and ensures integration of Quality and Risk Adjustment metrics into the overall process.
  • Implements and maintains Quality and Medicare Risk Adjustment improvement actions for the largest, most complex state and provider programs.
  • Keeps in constant communication with practices for support, continuing education and ad-hoc discussions.
  • Prepares and participates in quarterly JOCs with presentation of high-level reporting to provider group leadership and follow-up on action items to completion.
  • Promotes engagement and oversight to ensure accurate and complete qualitative and quantitative analysis of HEDIS and Medicare Risk Adjustment data with sharing of results to appropriate provider team(s).
  • Assures compliance with Corporate Quality and Risk Adjustment work plans.
  • Maintains effective documentation of Quality and Risk Adjustment programs to meet regulatory and accreditation standards.
  • Recommends activities to enhance member satisfaction and improve overall health outcomes.



Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.

Current unrestricted license, certification in applicable field (i.e. RN or LMSW) and/or a MS in the health field is preferred. HEDIS, Medicare risk adjustment experience strongly preferred. 


Applicable to Colorado Applicants Only

Annual Salary Range*: $75,244 - 94,055

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

 * The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting.  The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future.  No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.


We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.  Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Denver, Colorado

If you are active-duty military, reserve, or a military veteran, we foster a welcoming environment that’s dedicated to honoring your service and helping you achieve your career goals. Veterans of Anthem — one of our Business Resource Groups — partners with our Talent Acquisition teams to maximize career offerings for you and your family members, striving to help you transition to civilian service and grow your career at the same time. 

Join Anthem's Military and Veteran Talent Network: 


Anthem, Inc. is currently seeking military veterans and military spouses for a variety of open roles.  Our immediate needs include Support Technical Engineer, Lead Engineer, Developer, Systems Analyst, Network Data Specialist, and Provider Network Manager roles.  Whether you are looking to transition into an IT career or if you have experience under your belt in the Technology field, Anthem wants to have an impact on your career and professional growth by speaking with you about their career opportunities.

If you are interested in learning more, check out Anthem's current open positions to the right for more information and to apply today!

Not sure where to start?  Send RecruitMilitary Success Manager, Taylor Groves, your questions at 

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