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Program Manager

Location:
JobFamily: Business Support
Req #: PS57749
Date Posted: Sep 17, 2021

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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 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.

Title: Client Services Program Manager for myNexus

Preferred Location: Brentwood, TN (Greater Nashville area)

About myNEXUS: myNEXUS, a proud member of the Diversified Business Group division within Anthem, Inc., is a fully delegated post-acute benefits management company focused on delivering innovative home and community-based product offerings. We provide comprehensive delegated management services to health plans and other risk-bearing organizations on an at-risk or fee-for-service basis for total medical expense related to Integrated Home Health, Stars Performance Improvement Program, Social Determinants of Health, Inpatient Avoidance and Clinical Programs.

As an energetic, polished, and passionate professional the Client Services Program Manager is responsible for a health plan clients’ success and satisfaction. As the day-to-day leadership contact for the client, the Client Services Program Manager will work closely with all departments and staff to ensure the highest level of client satisfaction as well as providing exceptional leadership that balances the “voice of the customer” with operational capabilities. This position will be directly responsible for managing the service requests, reporting, and performance standards of assigned clients. This position will be effective at achieving client retention, service measures, and growth goals through fostering internal and external relationships while balancing decision making needs of the client with company current and future capabilities.

Primary duties may include, but are not limited to:

  • Confident client leader and active individual contributor responsible for retention and service delivery of assigned clients and related client business
  • Effectively communicates myNEXUS’ program results, processes, and policies with health plan clients with demonstrated understanding of healthcare benefit administration, network contracting, and authorization/claims payment cycle
  • Execution of client-facing deliverables and maintain a high level of customer satisfaction; primary owner of client project plans and timelines
  • Develop all necessary program and data milestones, projects plans, risk assessments, status reports, and meeting agenda/minutes adhering to department standards for quality & consistency in a timely manner
  • Responsible for coordination, preparation, and accurate / timely delivery of all assigned client contractual and regulatory requirements including but not limited to client reporting and service level agreements
  • Monitoring, usage, and control over the Client Services tracking system service requests; develop and maintain high quality Client Services reporting and KPI performance measurement for service requests
  • Investigates, researches, and resolves issues presented by the customer; analyzes trends, develop customer specific solutions in collaboration with cross-functional teams; applies appropriate delegation and oversight of resources when applicable
  • Responsible for coordination, preparation and presentation for Joint Operating Committee meetings with assigned health plan customers, including finalization of deck and support materials; reviews financial and clinical outcomes, ensures customer understanding, problem solves and finds opportunities to increase presence

 

Qualifications

  • BA/BS 
  • Minimum of 5 years external client facing experience in program/project management
  • Any combination of education and experience, which would provide an equivalent background.

Preferred candidate skillset/ experience:

  • Graduate degree preferred.
  • Project management certification preferred.
  • Prior experience in managing external client relationships / account management; supported interactions with health plans across their national, regional and local enterprises while managing complex customer matrixes and competing stakeholder priorities
  • Prior experience and excellent verbal and written communications with varied levels including senior executives, I/T, and staff associates
  • Prior experience working in utilization management
  • Strong meeting facilitation skills are required; extensive experience and knowledge in facilitating group decision making and driving process improvement is required
  • MS Office skills of Word (intermediate), Excel (intermediate), PowerPoint (intermediate)
  • 5+ Years of health care experience; solid understanding of health care benefit administration

 

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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions

Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.