Anthem Dir I GBD KY Ops in Louisville, Kentucky
/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 willdrive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.
Responsible for operational management of state Medicaid Health Plan. Primary duties may include, but are not limited to: * Develops, directs, plans, and evaluates the goals and objectives of regional area within a State Health Plan. * Along with State President and senior management team, establishes overall standards, policies and objectives for Health Plan in accordance with applicable regulatory requirements; ensures alignment and support with overall Medicaid Business Unit mission, goals and objectives. * Leads Health Plan operational processes including state Medicaid regulatory program and contract changes, cost of care operational implementations, benefit configurations, provider network data and contract configuration, and claims appeals and resolution. * Oversees management of all vendors. * Oversees performance of corporate support services. * Solves complex operational, financial, legal, and politically sensitive issues. * Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires BA/BS degree in a related field; excellent verbal and written communication skills; Proven experience leading cross-functional teams; 8-10 years of relevant experience including in-depth experience in the HMO/healthcare field including benefit and enrollment management, provider reimbursement methodologies and claims payment processes, healthcare data processes and analytics, contract implementation and management; 5 years working with Medicaid programs; or any combination of education and experience, which would provide an equivalent background. Master’s degree preferred Six Sigma and Project Management certification is a plus.
/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.__/
Job Business Support
Title: Dir I GBD KY Ops
Requisition ID: 129810