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Manager l GBD (Medicaid) Special Programs

This job posting is no longer active.

Location: Louisville, KY
Job Family: Business Support
Req #: PS42290
Date Posted: Dec 22, 2020

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 care companies and a Fortune Top 50 Company.


Manager GBD (Medicaid) Special Programs (PS42290)

 

Location: This position will allow you to work from home in the Louisville, KY area but will likely be office-based in the future.

 

The Manager l GBD Special Programs is responsible for managing and overseeing utilization management, non-clinical team responsible for coordination of a comprehensive health care program in which members needs are identified, including physical health and social services for the Kentucky Medicaid Plan. Primary duties may include, but are not limited to:

  • Manages resource utilization to ensure appropriate delivery of care to members, adequate coverage for all tasks and job responsibilities.
  • Coordinates service delivery to include member assessment of physical and psychological factors.
  • Participates in cross-functional workgroups created to maintain and develop program.
  • Evaluates current processes of Medicaid support functions; recommends changes for increased efficiencies and improved outcomes.
  • Develops and conducts training programs for staff involved in the program.
  • Extracts and manipulates analytical data to present findings to relevant markets and stakeholders.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports. 

Qualifications

Requires:
  • BA/BS; 5 years of experience in a related field, including 1 year of leadership/management experience; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN, LSW, LPC, or LPN/LVN license in the state of Kentucky.
  • Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred.
  • Knowledge of Utilization Management required.
  • Knowledge of Kentucky Medicaid experience preferred.
  • Requires availability to respond to urgent questions from direct reports as needed during non-business hours, i.e. evenings, weekends, holidays.
  • Knowledge of NCQA preferred.
 

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.

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