Anthem Inc. Medical Jobs

Job Information

Anthem, Inc. Staff VP, Enterprise Delegation Oversight in Cary, North Carolina

Description

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.

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 care companies and a Fortune Top 50 Company.

Responsible for leading the Enterprise Delegation Oversight team, managing, and auditing delegate performance for delegated functions across the enterprise.

Primary duties may include, but are not limited to:

  • Lead and participate as the subject matter expert in internal and external audits conducted by regulatory bodies such as state and government agencies.

  • Directs efforts to compile information related to quality improvement and adherence monitoring activities and maintains relevant records.

  • Provides decision support and recommends and articulates improvements or remediation to risk management and regulatory compliance programs up to and including the recommendation of de-delegating where appropriate.

  • Ensure delegated functions are being executed according to contractual terms while also maintaining compliance with Federal and State requirements while overseeing the implementation of corrective action plans if non-compliant.

  • The position also requires enterprise collaboration across all lines of business working with health plan and corporate stakeholders.

  • Hires, trains, coaches, counsels, and evaluates the performance of direct reports (auditors and compliance managers).

Qualifications

  • Requires a BA/BS degree and 12 or more years or any combination of education and experience, which would provide an equivalent background

  • 5+ years of management experience with direct report responsibilities including the oversight of large teams in a health care environment

  • 4+ years of compliance/regulatory and/or auditing experience

  • Demonstrated experience advancing in career-specific to operational excellence within compliance and regulatory position in healthcare

  • DMHC experience specific to The California Department of Managed Health Care

  • Experience working in a complex matrix environment within a managed care or payor organization and/or the equivalent

    Preferred requirements:

  • (MCO) Managed Care Organization experience related to Commercial business within the Healthcare Industry.

  • Six Sigma Certified

  • Extensive Project Management experience

  • Proven strategic planning experience

  • MBA 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.

    REQNUMBER: PS51293-US

DirectEmployers