President Medicare Central Region

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Company: Anthem, Inc.
Location: United States

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The President, Medicare Central Region has primary responsibility to be the vision leader for the fiscal, operational, legislative, regulatory, human resources and profitable growth objectives in adherence with corporate policies, procedures, state regulations and laws that govern the areas within our Central region. The ideal candidate will leverage resources and partnerships, internally and externally, to spearhead Anthem’s Government Business Division efforts to address the needs of our aging population, providing direction for high quality of care and continued business growth.
Our Central Region includes Ohio, Indiana, Kentucky, Wisconsin, Tennessee, Louisiana and Missouri, aimed at delivering meaningful solutions to consumers, the communities served, its care providers and federal agencies. The position oversees strategy, financial performance, growth and operational execution across assigned Medicare health plans and Alliance/JV collaborations, serving more than $500k members in Anthem communities.
Anthem’s Medicare portfolio of products includes:
  • Medicare Supplement
  • Medicare Advantage
  • Group Retiree Solutions
  • Part D
KEY RESPONSIBILITIES

Achieving Annual Operating and business objectives around operating gain, growth, cost of care commitments, revenue, and meeting or exceeding quality and accreditation goals are central to success, and this position will:
  • Refine and execute the central region Medicare strategy to meet growth and financial performance to support Anthem’s overall value proposition- driving top-line and bottom-line growth, ensuring course corrections are taken to drive continued profitability and long-term viability.
  • Drive initiatives and innovation across the Central region footprint to improve cost of care and quality of care/outcomes for members, provider partners, governmental partners and other key stakeholders
  • Create and lead initiatives resulting in improved customer retention, improved competitive positioning and increased customer and earnings growth, in part through driving operational execution and development of strong brand reputation in the marketplace and community
  • Ensure network strategies and relationships with provider communities support all product lines in terms of cost, quality outcomes, consumer access, and market competitiveness
  • Create a high performing team where direct reports and shared services partners are accountable to exchange knowledge, information and best practices related to Government business to ensure financial goals/objectives are attained through increased operating performance across the central region Medicare footprint and products
  • Collaborate and coordinate with leadership in other lines of business within Anthem to ensure optimal organizational efficiencies across all functional disciplines
  • Actively participate in the political and legislative processes, and provide leadership and direction relative to contract negotiations. Ensure highly productive relationships and partnerships for the benefit of the organization
  • Develop and implement regional and local contract structures and reimbursement methods to align with provider network to improve the measureable performance of the central region markets and improve the quality of care for health members. Maintain these relationships to improve total medical cost and position the market and matrix partners for growth opportunities
  • Develop, manage and provide oversight of key regulatory and legislative relationships and processes, including premium rates, covered populations, eligibility, benefit design, networks, administrative requirements, and new products. Represent the Medicare business unit at legislative sessions, committee meetings, policy meetings and other functions as needed
  • Provide oversight of the risk management program, including fraud and abuse program compliance and reporting responsibility. Identify threats to financial assets, reputation, and human resources
  • Educate and influence stakeholders in prospecting business opportunities and best practice sharing. Seek and develop business endeavors that have a value proposition for the region. Leverage assets, resources and expertise in current health plans, and collaborate across the organization
Additionally, the ideal candidate will:
  • Promote organizational cultural values and behaviors. Ensure regular coaching, timely performance management and active mentoring. Assess and develop bench strength and retain talent in accordance with associate retention and development goals.
  • Ensure Sarbanes-Oxley (SOX) compliance and meet other key manager goals and metrics.
  • Manage and participate in the development of growth strategies, branding and retention initiatives..
  • Direct and participate in relationships with key hospital systems, large physician practices/clinics and key ancillary providers such as dental and vision contractual relationships in region.
  • Oversee internal communications ensuring support for company values, liaison with corporate personnel and external communications with the State, providers, members, community groups and the media.
  • Oversee corporate shared/support services and service operations interface with health plans.
  • Administer state contractual compliance and HIPAA compliance across the region, including securing resources necessary for such compliance.
  • Assist with and/or lead corporate projects, acquisitions, and due diligence initiatives

PROFESSIONAL EXPERIENCE/EDUCATION
Bachelor’s degree in a related field
(Master’s preferred)Minimum of 15 years in program healthcare
and/or integrity-related field, and 5+ years’ executive level experience or
P&L responsibilityExperience working in a senior
leadership position for a managed care organization preferred, ideally with specific
public sector managed care experienceComprehensive knowledge
of HMO/Healthcare systems and to improve quality of care and reduce costsStrong financial management,
organizational, negotiation, analytical and management skillsHighly effective interpersonal and
relationship building skillsPrior success in a fast-paced environment and
follow-through management styleStrong work ethic, keen performance
orientation, along with an appreciation and embrace of the company’s mission
and member populationDemonstrated
successful leadership skills in program
management, program execution, people management Successful
leadership and management experience building
effective teams, managing cross functional teams, and continuous improvement/staff development
programsDemonstrated superior oral/written
interpersonal communication, persuasion, and negotiation skillsStrategic thinking and demonstrated
organizational leadership capabilities required Key skills include analytical ability,
innovation and creativity, teamwork and communicationsAbility to successfully interface at all
levels with the customer, industry, and corporate entities
*Position located in the Medicare Central Region in Anthem’s Medicare Health Plan offices, with
expected regional and nationwide
travel.