/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.
The Solutions Management Director is responsible for leading the planning and implementation of products and services for the most complex, diverse lines of business enterprise wide. Serves as the single point of contact and subject matter expert on all aspects of planning, implementing and managing day to day operational, technical and business partner interactions for existing programs and works together with Product Development to consult on enhancements to existing products and development of new clinical solutions based on department analytics.
Primary duties include, but are not limited to:
Explains timelines and measures of success for implementing these products.
Coordinates with the Physician Liaison regarding clinical issues related to clinical measure implementation or customization by line of business and communicates changes to Product Development for consideration in product performance and financial analyses.
Schedules and coordinates implementation of contracted products and services for assigned business partners.
Coordinates data requirements, production schedules and deliverables with the business partner.
Oversees all business partner specifications and/or modifications for contracted products and services.
Provides business partners with the resources, training and services necessary to effectively utilize the products that provides.
Analyzes business partner data for QA and identification of opportunities for business partners to utilize products and services to improve plan performance.
Maintains expert knowledge of current clinical measures and future clinical measure development plans, communicates this information to business partners, assists in the selection of clinical measures to be utilized in pilot and full rollout of products and services, and guides business partners in continually reviewing and updating clinical measure sets.
Maintains expert knowledge of all current systems, products and services and basic understanding of future system and product development plans to allow appropriate level of communication with business partner.
Leads department projects and mentors solutions management staff.
Provides leadership to managers and consultants.
Serves as subject matter expert for the department.
Directors typically support business strategies through an integrated portfolio of programs, projects and initiatives.
8-10 years of experience in related field
3-5 years Solutions Management experience
Knowledge of Claims processing systems required-preferably FACETS, NASCO, or WGS
Ability to develop executable business processes
Ability to assess needs and build resource plans accordingly
Ability to develop and execute work flows
Ability to manage matrixed resources
Knowledge of project management methodology
Ability to build and manage project plans
Ability to assess, build, and execute operational readiness plans
Benefit administration knowledge preferred
Graduate degree and/or professional designation and experience required
Project management experience preferred
or an equivalent combination of education and experience required.
/Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2016 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./
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Equal Employment Opportunity Statement
Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.
Title: Solutions Mgmt Director-Remote/Nationwide-#133637
Location: louisiana-Baton Rouge
Requisition ID: 133637
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