Anthem CM Business Solutions Director - Nationwide (DC Area Preferred) - Remote Work Available - PS7290 in Andover, Massachusetts

CM Business Solutions Director - Nationwide (DC Area Preferred) - Remote Work Available - PS7290

Location: United States

Field: Business Development/Planning

Requisition #: PS7290

Post Date: Jun 21, 2018

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 atone of America's leading health benefits companies and a Fortune Top 50 Company.

Responsible for coordinating the development of business requirements for the design and evaluation of solutions for a portfolio of components for the network and benefit and product strategy in payment innovation.

Primary duties to include, but are not limited to:

  • Helps to define the information along with the analytic and operational requirements needed to support implementation of particular components of the network, benefit and product strategy.

  • Facilitates discussions and meetings among subject matter experts within relevant areas of the business, which may transcend single business unit boundaries, in order to document anticipated process flows that will be needed to implement particular payment innovation initiatives.

  • Within each component of the anticipated process flows, defines the supporting data and data analytic needs, as well as the requisite operational capabilities. Works with business owners to describe operational changes, as well as the anticipated changes in administrative costs, costs of care and membership that would result from implementation of a particular component of the product, benefit and network strategy.

  • Develops high-level, multi-year work plan, including tasks, required staff and project timetable and works with executing company or business segment to translate high-level work plans to initiative level project and execution plans. Works with IT business requirements managers (BRMs) to compare the supporting data and data analytic needs, as well as the requisite operational capabilities, to current state and to define solution requirements in sufficient detail to enable IT personnel to define potential solutions.

  • Facilitates discussions between business owners and IT personnel regarding the relative advantages and disadvantages of particular solution designs and potential modifications to those designs that might result in desirable tradeoffs between different parameters.

  • Develops plans for implementation of pilot tests that should include tasks, personnel, timelines, milestones and the design of the evaluation of the pilot test that will enable us to determine whether to expand, refine, or discontinue particular care management initiatives.

  • Requires a BA/BS degree in a related field; 8- 10 years of healthcare experience in operations, project/program management, research and or business analysis including 3 years experience in consulting to health care organizations; or any combination of education and experience, which would provide an equivalent background.

  • MBA preferred.

  • Some knowledge of performance based contracting and value based insurance design preferred.

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.