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Anthem, Inc. Vendor Compliance Manager- Medicaid Health Plan in Jackson, Mississippi

Description

SHIFT: Day Job

SCHEDULE: Full-time

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 care companies and a Fortune Top 50 Company.

Location: Must be in commutable distance to Jackson, MS office - will travel onsite approximately 50% of the time

The Vendor Compliance Manager- Medicaid Health Plan is responsible for being the primary liaison between vendors/subcontractors (e.g. Doral Dental, VSP, etc.) and State Sponsored Business in relation to meeting state contractual requirements and federal/state laws.

Primary duties may include, but are not limited to:

  • Obtain, review, analyze and roll up as needed required reports from vendors and submit to contract advisors as needed for reporting to the state.

  • Develop and populate monthly report cards to monitor performance guarantees of vendors/subcontractors.

  • Participate in Health Plan Magellan Collaborative Committee and participate in Service Committee bringing required reports for each vendor as needed.

  • Set up vendor oversight meetings bi-annually to review contractual requirements, reports and performance.

  • Audit vendor for contractual compliance and monitor any corrective action plans needed from vendor.

  • Participate in negotiations for contracts in terms of past and future performance guarantees and performance results.

Qualifications

Minimum Requirements

  • Requires a BA/BS and minimum of 6 years compliance experience; or any combination of education and experience, which would provide an equivalent background.

    Preferred Qualifications

  • MS/MBA preferred.

  • Detailed knowledge of MS state Medicaid compliance requirements and experience working with state programs preferred.

    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. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

    REQNUMBER: PS60016

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