Director I Medicaid State Operations Job in Atlanta, GA at Anthem


Anthem Atlanta, GA


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.

Director I Medicaid State Operations

Develops, directs, plans and evaluates the goals and objectives of the business unit for assigned State. Primary duties may include, but are not limited to:

Establishes state/regional strategic plans and objectives to meet business unit goals. Assumes leadership role in implementing corporate initiatives, including special project planning and budget management. Resolves complex financial, legal, or politically sensitive issues. Leads program development to ensure members, network providers, and community partners successfully participate in programs. Manages local provider network including network assessment and development, issue identification and contractual issues (PCP, specialist, hospital, and ancillary). Plans, directs, and secures the resources (people, material, data and support) for staff to effectively accomplish operational needs and strategic initiatives. Maintains appropriate staffing levels and provides oversight of indirect reporting associates. Motivates associates to accomplish goals and objectives. Develops and implements budget and a strong team through training and effective organizational development practices. In collaboration with and in support of the National Field Operations, assumes all management functions for a state/regional/field office. Ensures all policies and procedures related to Field Operations are compliant with all applicable laws and regulations governing the State Sponsored Business. Champions initiatives by developing and managing State rate negotiations and key relationships with government, regulatory, Medicaid/SCHIP and other stakeholders as appropriate. Provides coordinated analysis and regional solutions to issues. Guides implementation of programs and strategies. Collaborates with senior management to develop and implement new programs to enhance relationships with key stakeholders and to promote programs and services. Collaborates with Marketing Management to develop marketing strategies for member recruitment and retention for all assigned lines of business. Directs strategic planning on marketing, network maintenance and development and program advocacy in assigned area. Resolves programmatic challenges related to program operations including member issues, provider claims and provider network. Manages projects and issues across departmental and divisional lines to facilitate timely resolution. Represents business unit on national/state/regional boards, task forces, and work groups that impact the health care delivery system and other key health care issues. Hires, trains, coaches, counsels, and evaluates performance of direct reports.  This position may be filled at a higher level based on experience.

Requires BA/BS degree in a related field; 8 years management experience in the health care field; specific contract negotiation experience in both provider network management and state rate contracting; or any combination of education and experience, which would provide an equivalent background. Masters degree preferred.

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 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.

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