Job Details

ID #2751626
State California
City Lamirada
Full-time
Salary USD TBD TBD
Source Anthem, Inc
Showed 2019-10-03
Date 2019-10-04
Deadline 2019-12-02
Category Et cetera
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VP Stars

California, Lamirada 00000 Lamirada USA

Vacancy expired!

VP StarsLocation: United StatesNewRequisition #: PS28725The Vice President, Stars, will have

primary responsibility leading efforts across our Medicare organization and the

broader enterprise to improve Star ratings. Central to this mission is ensuring preventive

and chronic care measures, member satisfaction, service and access to care

measures improve, keeping Anthem competitive and viable in the industry. In

addition this person will also lead the quality and performance incentive

office to track and manage programs for the performance-based withhold and

bonuses in Medicaid Includes training of staff for efficiency and

effectiveness.The ideal candidatewillleverage resources and partnerships, internally and

externally, to spearhead Anthem’s Government Business Division efforts to

address the needs of our aging population, providing direction for high quality

of care and continued business growth.

Responsiblefor building an enterprise Stars predictive analytics and performancemanagement reporting functionality to drive year over year Stars performanceimprovement.Will require thedevelopment and implementation of predictive analytics to help determineoptimal operating model and strategic focus for interventions.Will also include creation and implementationof innovative dashboard(s) and scorecard(s) to demonstrate results on a morereal time basis. Will lead performance-based withholds and bonuses for Medicaidimprovement. Achieve financial objectives and capitalize on opportunities todrive profitable growth.

Advocatewith CMS policy for future revenue streams.Ensures compliance with Centers forMedicare and Medicaid Services (CMS) guidelines as trusted protector ofgovernment resources.

Driveexecution in complex cross functional environment with sharedresponsibilities and competing priorities.Requires navigating the matrix, influencing without directauthority and fostering a collaborative work environment todrive impact

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

KEY RESPONSIBILITIESOversight/DottedLine Responsibilities:In partnership with all Medicare leadership,

drive results to improve STAR ratings through shared services verticals

includinga. Member Experience lead (CAHPS, exclusive of flu

vaccination)b. Clinical Quality Lead (HEDIS, HOS, flu vaccination,

SNP HRA)c. Part D Quality Lead (pharmacy measures- e.g.,

adherence, MPF, price accuracy, pharmacy benefits plan satisfaction)d. Medicareand Medicaid

RegionalQuality Regional quality leaders - Development

and execution of regional strategies and interventions, supporting development

of enterprise strategy

Bachelors degreein Healthcare Economics, Business Administration or an equivalent combinationof education and work related experience. Preferred: Masters degree in HealthcareEconomics, Business Administration or similar field.

At least 14years relevant Medicare work experience including ten years of in-depthexperience in the HMO/healthcare field with at least ten years of proven leadershipexperience.

Experience withhealthcare economics and/or risk adjustment; CPC or CCS-P certificationpreferred.

Projectmanagement of large scale business change, strategy development and executionexperience required.

Preferred: Experience working in a senior managementposition for a managed care organization ideally with specific experience inMedicare and/or Medicaid managed care; functional competencies includingcomprehensive knowledge of HMO/healthcare systems and how they can work toimprove quality of care and reduce costs; strong financial management,organizational, negotiation, analytic and management skills; experiencemanaging advanced analytics (e.g., prospective analysis) to inform design of interventions;highly effective interpersonal and relationship building skills with provenability to communicate effectively across the board range of people; priorsuccess in a fast-paced environment.

Vacancy expired!

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