Manager Oversight Compliance – Anthem Office – PS36089

Remote Jobs Anthem in Law
  • United States, Remote View on Map
  • Post Date: June 18, 2020
  • Apply Before : July 18, 2020
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Job Description

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 benefits companies and a Fortune Top 50 Company.

This position is required to work from one of the following office locations. However due to the pandemic, this position is approved to work remote until the offices reopen.

  • Norfolk, VA
  • Atlanta, GA
  • Louisville, KY
  • New York, NY
  • Indianapolis, IN
  • Woodland Hills, CA
  • Tampa, FL
  • Wallingford, CT


Manager Oversight Compliance

Responsible for managing clinicians responsible for ensuring compliance of delegated entities and internal company clients with regulatory, accrediting and health plan quality of care and service requirements.

Primary duties may include, but are not limited to:

  • Develops and manages favorable working partnerships and relationships with delegated entities, physicians, healthcare service providers, and internal customers to improve the delivery and quality of health care.
  • Manages annual and ad hoc delegation oversight audits, analyses of performance measures, reporting, and development of corrective action plans.
  • Leads intervention activities to enhance communication and educate.
  • Designs programs and strategies to assist delegated entities in meeting standards and improving quality outcomes.
  • Develops operations processes and ensures standardization of procedures and documentation.
  • Negotiates with delegated entities and internal constituents as needed.
  • Leads healthcare industry initiatives that involve the standardization and streamlining of regulatory oversight functions.
  • Provides support for litigation issues surrounding regulatory compliance.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

  • Requires a BS; 6 years of acute care, utilization management, quality management in a hospital and/or HMO setting
  • Min of 3 years of management experience
  • Min of 3 years of experience in conducting oversight audits of delegated entities and/or ancillary providers
  • Current unrestricted RN license in applicable state(s) required.
  • May require some travel

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

 

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