Anthem, Inc. Mgr II Systems Suprt & Prgrms in Iselin, New Jersey
SHIFT: Day Job
Beacon Health Options: Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, 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.
For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Responsible for driving service quality excellence by evaluating the quality of services and interactions provided by Provider Data within the enterprise and externally, and developing and executing operational readiness plans for tactical and strategic provider experience initiatives. Included are processes related to provider and pricing configuration, and respective upstream and downstream processes, as well as provider inquires and issue resolution. Responsible for driving service quality excellence by evaluating the quality of services and interactions provided by Provider Data within the enterprise and externally, and developing and executing operational readiness plans for tactical and strategic provider experience initiatives. Included are processes related to provider and pricing configuration, and respective upstream and downstream processes, as well as provider inquires and issue resolution.
Operational Provider Data configuration.
Health Plan Provider Data experience preferred.
Experience with Health Plan Provider Data contracting / rate management preferred.
Leads process improvement process to improve data quality, standardization of processes and operational readiness plans for provider experience.
Leadership experience required.
Cross functional project management.
Leads interactions with business, vendor partners, and clients, presenting contractual and quality program results, reviewing discrepancies, implementing action plans, identifying process improvement opportunities, and performing calibration sessions for various quality scenarios.
Responsible for using intelligence, operational management skills and judgment to anticipate problems and to provide solutions that exceed the demands of the customers’ operational expectations and business needs.
Primary duties may include, but are not limited to: Manages the day-to-day configuration activities of the Business Solutions area of Health Plan Services.
Analyzes business requirements and objectives towards determining the optimal configuration of the requirements used to support health plan operations.
Coordinates and directs all configuration-related activities to meet project deadlines.
Ensures that service levels meet agreed-upon standards with business owners.
Conducts gap analysis discovery between business requirements and system functionality.
Acts as the business subject-matter expert to other implementation initiatives, including conversion, and interface development.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires a BA/BS in Business Administration, Information Science, Computer Science, or Industrial Engineering.
7 years of technical and/or systems experience; 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 has been named a 2019 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.