SHIFT: Day Job
<span style=”font-family:”Times New Roman”,serif”>Responsible for financial leadership, decision support, and strategic consultation to the Ohio<span style=”font-family:”Times New Roman”,serif”> Medicaid Health Plan leadership team. Directs health plan financial analysis, cost of care analytics, trend analysis, financial reporting, financial operations, and cost and budget management and allocation in a Health Plan with an assigned product or portfolio, which may include specialty products and/or provider contracting arrangements that carry financial risk to the plan P&L, serves as legislative consultant with state partners on financial/reimbursement policy and payment mechanisms.
<span style=”font-family:”Times New Roman”,serif”>Primary duties may include, but are not limited to:
- <span style=”font-family:”Times New Roman”,serif”>Directs market leadership for P&L and SG&A budget; operates as a financial liaison to state partners; leads rates management and negotiation including reserve development and analytics; and leads the Medical Cost and RX Trend identification and mitigation process with key business partners including network and clinical teams.
- <span style=”font-family:”Times New Roman”,serif”>Maintains trends that are appropriate given premium reimbursement.
- <span style=”font-family:”Times New Roman”,serif”>Reviews, analyzes, reports, and presents financial results. Provides decision support for business unit President and senior management teams’ operational and business goals.
- <span style=”font-family:”Times New Roman”,serif”>Achieves Medical Cost and MLR targets set in plans and forecasts; may ensure that provider network contracting efforts obtain the best possible financial arrangements; may own the setting of and achievement of Cost of Care targets; and achieves operating gain targets set in budgets and forecasts.
- <span style=”font-family:”Times New Roman”,serif”>Directs Health Plan preparation of annual operating/capital budget and forecasts to provide senior leadership with tools necessary to maximize investment of resources.
- <span style=”font-family:”Times New Roman”,serif”>Directs interface with regulatory and audit personnel and technical consultants as required to ensure fiscal accountability.
- <span style=”font-family:”Times New Roman”,serif”>Supporting the pricing actuaries on premium rate actions.
- <span style=”font-family:”Times New Roman”,serif”>Representing the health plan at key state and provider meetings; oversees the processing and delivery of several major provider pass thru payments; and is a key member of the Ohio leadership team.
- <span style=”font-family:”Times New Roman”,serif”>Helping to support the plan president on setting and achieving health plan goals.
<span style=”font-family:”Times New Roman”,serif”>Requires a BS/BA in Finance, Business Administration, Economics or Accounting; 8-10 years of progressive financial experience accounting, financial reporting, business analysis, budgeting, forecasting, and strategic and tactical planning within a health insurance/managed care environment; experience with complex business environments including multiple entity and highly regulated situations; or any combination of education and experience, which would provide an equivalent background.; MBA preferred. Significant experience working with shared savings arrangements is strongly preferred. Medicaid managed care experience 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 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.
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