Our Ability Jobs

Job Information

Anthem, Inc. Medicaid QM Portfolio Dir in Columbia, South Carolina

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s 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.

The Medicaid QM Portfolio Director is responsible for developing specific national strategies for Medicaid Quality domains in support of GBD, the Medicaid business, and State partner requirements.

Primary duties include but are not limited to:

  • Provides leadership to Quality Improvement projects that are cross-organizational in nature.

  • Supports various BU leads in developing tactical state-specific plans and strategies and promulgating best practices across the Medicaid business.

  • Assists executive leadership in assessing current environment, external factors, competitive landscape, and facilitates development of key strategies.

  • Coordinates with National Medicaid Quality VP and State Plan Presidents to align BU strategy with the overall GBD strategy and plan(s).

  • Identifies opportunities to coordinate across lines of business more effectively to optimize value.

  • Engages business planning leaders within the respective GBD and shared services areas (including but not limited to Enterprise Quality, Provider Services, and Clinical Services teams) to identify innovative solutions and efficiency opportunities to achieve performance targets, achieve market distinction, successfully deliver value-based payments from State partners, reduce and eliminate Quality-related sanctions, improve accreditation scores, and increase NCQA-STAR ratings.

  • Evaluates strategic options in the context of the GBD strategic direction, financial targets and market context. Helps evaluate/re-evaluate ongoing initiatives in light of the changing environment to recommend corrective action.

  • Supports the preparation and facilitation of planning sessions with the corporate leadership.

Qualifications

  • Requires a BA/BS degree in a related field;

  • Pharmacist preferred

  • 10 years of experience with significant large-scale project management, strategic planning and/or consulting in the health care industry; or any combination of education and experience which would provide an equivalent background.

  • Requires a strategic thinker with a broad & deep understanding of the health care industry and the ability to develop and execute logical analysis to drive toward key decisions.

  • Master’s degree preferred.

  • Ability to travel may be required.

AnEqualOpportunityEmployer/Disability/Veteran

REQNUMBER: PS42494

DirectEmployers