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Medicare Business Relationship Director - GA, NC, SC, AL, FL, VA - PS13392 in Atlanta, GA at Anthem, Inc.

Date Posted: 12/17/2018

Job Snapshot

Job Description

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.

Medicare Business Relationship Director
Work location: Georgia, North Carolina, South Carolina, Alabama, Florida, Virginia; Atlanta, GA strongly preferred 
Responsible for providing leadership and coordination of business relationship management strategy, process improvement, and support activities for the Medicare Business. Responsible for oversight of the P&L and Profitable Membership Growth for Medicare Advantage for the State of GA account.
Primary duties may include, but are not limited to:
- Partners with executive leadership to define relationship strategy and success criteria for the future.
- Translates strategy into defined tactics, programs/projects, priorities and timelines.
- Ensures alignment and attainment of enterprise relationship plans.
- Oversees development and implementation of metrics to report and monitor progress against goals and ensures plan of record supports strategy milestone deliverables.
- Monitors, measures and communicates delivery against business strategic plan and the quality of outcomes.
- Collaborates with Medicare team and develops tactical plans and communication strategies.
- Builds and leverages relationships to provide innovative solutions to complex business problems.
- Serves as the subject matter expert in projects and initiatives.
- Identifies areas of opportunity to increase efficiency and maximize revenue opportunities.
- Proposes opportunities to improve results based on continuous needs assessment.
- Oversees definition development and implementation of metrics to report and monitor progress against goals.
- Responsible for plan design management. 
- Strategic planning and coordination and collaboration with multiple matrix partners. 
- Oversees the day to day activities and ongoing management of profit and growth initiatives, product oversight, and strategy.  
- Responsible for specific op gain and membership goals as defined by the annual plan. 
- Client facing to resolve any escalated concerns and deliver quarterly reports on progress.
- Collaborates with internal teams to improve MA plan offering and revenue enhancements to gain profitability.
Collaborates with other departments within Medicare and many matrix partners within Anthem including Finance, Actuarial, IT, and HCM. The position will be the primary point of contact/ client facing for the Medicare Advantage business for the State of GA account and will be responsible for ensuring the Medicare Advantage contractual requirements are met. Will act as a liaison with Sales, Marketing, UW, Actuarial, Operations, PBM, Risk and Recovery, Care Management, Stars, Legal, Compliance and other stakeholders to ensure contractual requirements are met for Medicare Advantage. Will work with Risk and Recovery, Stars team, Care Management team and other stakeholders to develop processes and implement programs to maximize CMS revenue and ensure operational and cost efficiencies. Will work with Product, Legal and Compliance to ensure CMS filings, including annual bid and network filings, allow maximum flexibility for Medicare Advantage and Part D plan designs and programs. Will remain up-to-date on CMS guidance (including annual Call Letter and other guidance) and assess the impact on the State of GA account and Medicare Advantage growth.
Requires a BA/BS degree in a related field; 10 years of experience in healthcare business with experience in finance, reporting and analysis, or project management that includes 5 years of recent experience with Medicare products; or any combination of education and experience, which would provide an equivalent background.
- Masters degree preferred.
- Excellent quantitative, marketing, financial, and strategic skills required. 
- Ability to travel required, including ability to drive/travel to Atlanta, GA as needed.  
- Previous client facing experience preferred. 

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.


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