Anthem Staff VP Risk Adjustment (139583) in Smithfield, Virginia

/ 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.

Responsible for designing, implementing and directing programs and initiatives related to Medicaid risk adjustment. Accountable for the accuracy and completeness of risk scores for the health plan. Primary duties may include, but are not limited to:

  • Designs programs, policies and procedures related to risk adjusted revenue.

  • Manages coding and auditing.

  • Communicates best practices and opportunities for improvement.

  • Collaborates with senior management to develop strategies and tactics that improve the accuracy of risk scores and reduce payment error risk.

  • Monitors established operations, tracks performance, and resolve deficits. Evaluates, contracts, and manages vendors.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

  • Candidate will be able to demonstrate competencies in business acumen, influencing, and executive presence. The role involves collaborating with senior leaders to drive business decisions

  • Candidate will be able to demonstrate competency in strategic thinking. The role involves setting strategic direction for risk adjustment at the corporate and regional levels. This area is evolving rapidly, and there is a mix of vendored and insourced operations, as well as a mix of regional and corporate operations.

  • Candidate will be able to demonstrate competency in operational management. Excellence in execution will differentiate successful programs from mediocre programs.

/ / Requires a BA/BS; 10 years of experience with healthcare economics and/or risk adjustment; or any combination of education and experience, which would provide an equivalent background / / / Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran. /

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Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.

Title: Staff VP Risk Adjustment (139583)

Location: virginia-Smithfield

Requisition ID: 139583