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