Anthem In. Case Management Jobs

Job Information

Anthem, Inc. Director Healthcare Management in North Miami Beach, Florida

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.

We are hiring for a Director of Healthcare Management for our Medicaid service line. 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.

Position can be remote

Primary duties may include, but are not limited to:

Manages care management delivery teams which may include Utilization Management, Case Management, and clinical programs.

Accountable for quality, high touch, customer responsive, and cost-effective care services in assigned markets – FL, GA, NC, SC

Leading and supporting regional care delivery teams including Utilization Management and Case Management programs in a matrixed environment

Manages medical loss ratio and evaluates medical trends

Partners with Clinical Shared and Specialty Services, Finance, and Regional Leadership to deliver market leading care management services, trend identification, root cause analyses and solutions to achieve engagement and quality outcomes

Develops and manages communications on Anthem Care Management (ACM) issues and opportunities

Develops and implements process redesign and programmatic improvements

Serves on internal and external quality and provider committees

Hires, trains, coaches, counsels, and evaluates performance of direct reports

Qualifications

Requires a BA/BS in Nursing

Master’s Degree preferred

10 years of experience in managed care/health care environment or related field, including 5 years of management experience; or any combination of education and experience, which would provide an equivalent background.

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. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.

REQNUMBER: PS46860

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