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Anthem, Inc. Staff VP Encounters (GBD) Medicare & Medicaid in Fresno, California
SHIFT: Day Job
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 benefits companies and a Fortune Top 50 Company.
Title: Staff VP Encounters
Location: Virginia Beach, VA or within commutable distance to a local office
Responsible for the strategic, design and management of the Encounters e2e program and team that supports the day to day Encounter intake, analysis and submissions to federal and state partners, as well as the implementation of company-wide initiatives
Primary duties may include, but are not limited to:
Oversees Encounters performance metrics ensuring timeliness, accuracy and completeness are met with state and federal partners for all lines of business
Oversees Encounters submissions, rejection management & resolution for all lines of business including internal strategic partnerships supporting the production of encounters as well as providing overall organizational leadership aimed at managing overall healthcare costs
Ongoing monitoring and management resolution for any potential penalties related to performance measurements of encounters submissions
Engages with internal business partners and IT to analyze the root cause, identify potential risks, find ways to improve upon performance and lead the needed changes
Develops and leads strategic innovative initiatives to deliver more value for state and federal partners. Consults and calibrates with senior leaders as well as vendors and outside organizations, being the face of Encounters for the Anthem enterprise
Identifies, develops, hires, trains, coaches, counsels, and evaluates performance of direct reports
Requires a BA/BS in business or related field; 15+ years of experience in Healthcare or Operations industry;
Advanced strategic planning, organizational, managerial, and leadership skills; excellent verbal and written communication skills, experience drafting proposal, obtaining consensus for approving and implementing future state processes and systems need to support strategic direction or any combination of education and experience, which would provide an equivalent background.
5+ Medicare and Government Medicare, Medicaid
5+ Claims payment processing
5+ Financial management
5+ Regulatory and/or government experience
Vendor Management experience
Claims and Encounters within Health Insurance
Six Sigma, Agile Methodology and Design Thinking
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 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.