Atlanta, Georgia

Description

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.

Medicaid State Operations Director

Behavioral Health provider relationship management to include servicing, reporting and joint ownership of Behavioral Health scorecards and BH quality incentive campaigns.

Responsible operations functions, including coordination between internal departments, ensuring the appropriate strategy, tactics and processes are in place to affect solid organizational operations and oversight.

Primary duties may include, but are not limited to:

  • Resolves programmatic challenges related to operations including member issues, provider claims issues, contract configuration issues, etc.
  • Serves as liaison to Health Plan support services, which could include: Claims, Enrollment, NCC, PDM/PDQ, configuration; Quality, Regulatory Compliance, IT, Reimbursement policy, etc.
  • Identifies opportunities for Operational Excellence and works to create seamless processes between shared services and the Health Plan.
  • Develops and implements key operational indicators to be used for monitoring and analysis of the Health Plan operations.
  • Serves as a liaison with state regulatory agencies when appropriate.
  • Behavioral Health provider relationship management to include servicing, reporting and joint ownership of Behavioral Health scorecards and BH quality incentive campaigns.

Qualifications

Requirements

  • Requires a BA/BS in Business, Healthcare Administration or related field and minimum of 10 years experience, including minimum of 8 years in-depth experience in managed care operations; or any combination of education and experience, which would provide an equivalent background.
  • 5 or more years or experience working with behavioral health programs

Preferred Qualifications

  • Masters or other advanced degree
  • Direct engagement with Regulators or auditors
  • RN or MSW license

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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. 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.

Atlanta, Georgia

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: https://anthemcareers.ttcportals.com/pages/military 

WE ARE HIRING

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 taylor.groves@recruitmilitary.com 

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