Anthem, Inc. Staff VP Service Operations - AFC - Tampa, Florida in Columbia, South Carolina
SHIFT: Day Job
*This position will be located in Tampa, Florida. Qualified candidates in this location or willing to relocate will be considered.
The Staff VP of Service Operations, America’s First Choice (AFC) enrollment, will oversee market-based operations as it relates to all value-based performance contracts, including claims, enrollment and billing, pricing configuration, CSNP management and business office project management.
Responsible for creating the strategy to improve processes and ensure service levels are maintained for claims processes, enrollment & billing processes, CSNP and other operations functions and contracts.
Identify and address root causes and primary trends to initiate plans for correction and improvements.
Establish plans to enhance operational collaboration and shared goals in order to achieve a high performing, cross-functional team.
Responsible for financial planning/budget programs and the coordination of operations expenses.
Lead re-engineering and other organizational improvements designed to increase efficiency, improve service and strengthen departmental relationships.
Promote continuous quality improvement throughout the organization.
Stays abreast of state/federal regulations.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
BA/BS in a related field or equivalent experience
Minimum 10 years’ experience leading Health Plan Operations
Minimum 3 years’ experience leading Operations for Medicare Advantage Plans
Experience managing Enrollment, Claims, and Billing operations for a Health Plan with 100K Members or more
Management experience in healthcare operations with budgeting and forecasting, process improvement, or planning experience
Demonstrated experience with value-based payment parameters
Experience with C-SNP management and verification
Experience with Pricing and configuration across platforms and vendors (Health Axis, Wipro & EDI Clearing House)
Experience with the connected nature of value-based care across payers, providers, practices, operations, technology, and analytics
Must be located in the Tampa Florida area, or willing to relocate there
Demonstrated strategic leadership with the ability to see the big picture
Ability to work closely with providers to collaborate on initiatives and influence decisions
A broad understanding of healthcare reimbursement methodologies
Analytical, quantitative, and financially focused
Outstanding relationship and business acumen
Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
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.