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Medicaid State Ops Director - Eagan, MN or Virginia Beach, VA - July Start Date (PS3068) in Eagan, MN at Anthem, Inc.

Date Posted: 5/23/2018

Job Snapshot

Job Description

Your Talent. Our Vision. At Anthem, Inc., the Government Business Division is focused on serving Medicaid, Medicare and uninsured individuals. Our commitment and focus on government health programs is the foundation upon which we’re creating better care for our members, greater value for our customers and better health for our communities. Join us and together we will drive the future of health care.  
Join one of the fastest growing businesses in a company with the largest and most successful Medicaid business in the nation. The associate in this position will be supporting members enrolled in the Minnesota Medicaid Program.
Location: Eagan, Minnesota or Virginia Beach office-based.
The Medicaid State Operations Director is responsible operations functions, including coordination between internal departments, ensuring the appropriate strategy, tactics and processes are in place to affect solid organizational operations and oversight. Primary duties may include, but are not limited to:
  • Resolves programmatic challenges related to operations including member issues, provider claims issues, contract configuration issues, etc.
  • Serves as liaison to Health Plan support services, which could include: Claims, Enrollment, NCC, PDM/PDQ, configuration; Quality, Regulatory Compliance, IT, Reimbursement policy, etc.
  • Identifies opportunities for Operational Excellence and works to create seamless processes between shared services and the Health Plan.
  • Develops and implements key operational indicators to be used for monitoring and analysis of the Health Plan operations.
  • Serves as a liaison with state regulatory agencies when appropriate.

  • BA/BS in Business, Healthcare Administration or related field; 10 years of relevant experience including 8 years of in-depth experience in managed care operations; or any combination of education and experience, which would provide an equivalent background.
  • Master’s degree preferred.
  • Six Sigma Black Belt preferred.
  • Knowledge of Minnesota Medicaid a plus.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran.