NGS SME (Provider Enrollment) II
DescriptionSHIFT: Day Job
Your Talent. Our Vision. At National Government Services (NGS), an independent subsidiary of Anthem, Inc. and one of the largest Medicare contractors in the country, 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.
This is an exceptional opportunity to do innovative work that means more to you and those we serve.
The NGS Subject Matter Expert II responsible for providing Subject Matter Expertise (SME) for a variety of Medicare Provider Enrollment programs and offering SME input to internal and external partners. The preferred location is Baltimore, MD and open to remote nationwide.
Schedule: Remote, Monday-Friday, 8a-5p
Primary duties may include, but are not limited to:
- Keeps knowledge and expertise current by reviewing Medicare policies, procedures, publications, program materials, etc.
- Researches newly deployed and/or pending Medicare Regulations (e.g. Change Requests and Joint Signature Memorandums: and provides impact summaries to the impacted stakeholders).
- As needed, participates in meetings with primary contractor and Centers for Medicare and Medicaid Services (CMS).
- Manages day-to-day interactions and relationships and acts as a liaison with primary contractor associates.
- May assist with process re-engineering and with project work.
- Leverage knowledge of Medicare Provider Enrollment processes and policy to contribute to the APS project and solution.
- Support the team as Subject Matter Expert on the product/solution while working with a variety of stakeholders to meet their needs.
- Work with the product owner and business analysts to gather, analyze, design, and document product requirements for IT solution.
- Requires BA/BS degree, 6+ years of Medicare experience; or any combination of education and experience, which would provide an equivalent background.
- Experience with Medicare Provider Enrollment
- Some travel required (10-15%).
- Previous experience in a leadership role
- Depth and breadth of enrollment policy knowledge as outlined in Program Integrity Manual
- Proven knowledge and experience of enrollment systems
- Experience working on Federal programs that are of high priority, visibility, and public-facing
- Experience and knowledge working in detecting and managing healthcare fraud, waste, and abuse
- Familiarity with agile framework and methodologies
- Experience in analyzing the business and functional impact of change requests (CRs)
- Familiarity with CMS XLC process including the CR process
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.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against Covid-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
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. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.
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.