Anthem is a Fortune 30 company and a leading health benefit company, with operating revenue of over $90 billion and over $60 billion in assets. Anthem serves over 40 million medical members, or one in every nine Americans. 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.
The President of Medicaid East has primary responsibility to be the vision leader for the fiscal, operational, legislative, regulatory, human resources and profitable growth objectives in adherence with corporate policies, procedures, state regulations and laws that govern the areas within an assigned region. In addition to the above, the President of Medicaid East will have focus and specialization as follows:
Lead strategic planning and development of the regional business plan, quarterly reviews and course corrections to ensure action is taken to drive continued profitability and long term viability. Oversee resulting regional budgeting and financial reporting, capital budget planning and management.
Drive initiatives and innovation across the region to improve cost of care and quality of care/outcomes for members, provider partners, State customers and other key stakeholders
Oversight of key functional areas including shared services and corporate support services that are responsible for providing critical dependencies to the business e.g. Claims, Customer Service etc
Partner with the Business Development group to determine the right opportunities, timing of potential acquisitions, growth within states, and to serve as the “face” for the organization. Identify and lead new business opportunities including partnership/alliance relationships.
Oversee the RFP lifecycle process with enterprise business and proposal development leaders for assigned markets. Build the leadership structure of the local plan and ensure that the organizational structure is optimized.
Drive the successful implementation and development of a new market or product post-RFP, including human capital resource allocation and deployment.
Work alongside other Regional leaders to exchange knowledge, information and best practices related to Government business to ensure financial goals/objectives are attained through increased operating performance across regions and business units.
Collaborate and coordinate with leadership in other lines of business within Anthem to ensure optimal organizational efficiencies across all functional disciplines.
Actively participate in the political and legislative processes, and provide overarching leadership and direction relative to contract negotiations with states in the East region. Ensure highly productive relationships and partnerships for the benefit of the organization.
Develop, manage and provide oversight of key State regulatory and legislative relationships and processes, including premium rates, covered populations, eligibility, benefit design, networks, administrative requirements, and new products. Represent the Region at legislative sessions, committee meetings, policy meetings and other functions as needed.
Provide oversight of the risk management program, including fraud and abuse program compliance and reporting responsibility. Identify threats to financial assets, reputation, and human resources.
Oversee the management of State health plan operations, including personnel, facility planning/maintenance, office administration, and business continuity and recovery planning. Drive consistency among health plan operations as appropriate.
Drive innovation and influence best practice sharing. Seek and develop business endeavors that have a value proposition for the region. Leverage assets, resources and expertise in current health plans, and collaborate to leverage the same across the organization. Key to success in this role, the ideal candidate will:
Promote organizational cultural values and behaviors. Ensure regular coaching, timely performance management and active mentoring. Assess and develop bench strength and retain talent in accordance with associate retention and development goals.
Ensure Sarbanes-Oxley (SOX) compliance and meet other key manager goals and metrics.
Manage and participate in the development of growth strategies, branding and retention initiatives for marketing in region.
Direct and participate in relationships with key hospital systems, large physician practices/clinics and key ancillary providers such as dental and vision contractual relationships in region.
Oversee internal communications ensuring support for company values, liaison with corporate personnel and external communications with the State, providers, members, community groups and the media in assigned region.
Oversee corporate shared/support services and service operations interface with health plans.
Administer state contractual compliance and HIPAA compliance across the region, including securing resources necessary for such compliance.
Assist with and/or lead corporate projects, acquisitions, and due diligence initiatives
CRITICAL SUCCESS FACTORS
Communication and Influence
Ask tough questions, challenge and engage leaders in conversation to ensure the right things happen for the business
Help leaders understand business implications of actions, influencing a change in direction as needed
Integrate key messages into all communications to ensure people understand how initiatives work together to support business goals
Maintain executive presence to influence direction and inspire confidence with Anthem’s senior leaders
Establish strategies that create or sustain competitive advantage
Think broadly and long-term, recognizing the impact of decisions and actions on Anthem’s membership, business and key stakeholders over time
Focus your people
Create an environment that enables and focuses people on the company’s mission and vision
Inspire superior performance by cultivating ownership and personal commitment to goals and objectives
Communicate strategic context to ensure people understand what we are doing and what drives them
Discontinue efforts not focused on critical business priorities
Executing for Results
Hold oneself to the highest standards of accountability; has the ability to drive change while maintaining operating effectiveness; integrates and aligns efforts across functions; monitors results; tackles problems directly and delegates effectively.
Direct Reports: 7, indirect reports: approximately 3350 associates
Bachelor's degree in a related field (Master's preferred)
Minimum of 15 years in program healthcare, and 5+ years’ executive level experience or P&L responsibility
Experience working in a senior leadership position for a managed care organization preferred, ideally with specific public sector managed care experienceComprehensive knowledge of HMO/Healthcare systems and how they can work to improve quality of care and reduce costs.
Strong financial management, organizational, negotiation, analytical and management skills.
Highly effective interpersonal and relationship building skills
Prior success in a fast-paced environment and follow-through management style.
Strong work ethic, keen performance orientation, along with an appreciation and embrace of the company’s mission and member population.
Demonstrated successful leadership skills in program management, program execution, and people management
Successful leadership and management experience building effective teams, managing cross functional teams, and continuous improvement/staff development programs
Demonstrated superior oral/written interpersonal communication, persuasion, and negotiation skills
Strategic thinking and demonstrated organizational leadership capabilities required
Key skills include analytical ability, innovation and creativity, teamwork and communications
Ability to successfully interface at all levels with the customer, industry, and corporate entities
*Position located in the Medicaid East Region in Anthem’s Medicaid Health Plan offices, with expected nationwide travel.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran