Government Business Division, Tennessee Medicaid

POSTED ON 3/29/2021 CLOSED ON 4/27/2021
Anthem Career Site Hired Organization Address Nashville, TN Full Time

Job Posting for Government Business Division, Tennessee Medicaid at Anthem Career Site

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.

The Government Business Division Finance Director is responsible for financial leadership, decision support, and strategic consultation to the leadership team in the Health Plan.  This role directs health plan trend analysis, cost of care, financial reporting and analysis, financial operations, cost and budget management and administrative allocations in the Tennessee Medicaid Health Plan, and serves as a key liaison and subject matter expert with our state customer on medical trends, financial/reimbursement policy, payment mechanisms and financial implications of program and benefit changes. 

Primary duties may include, but are not limited to: 

  • Health plan P&L owner along with plan president and other functional leaders. 
  • Serves as key health plan leader providing financial and strategic insight to other health plan functional areas; operates as a liaison with state partners; leads reimbursement management and negotiation; owns the Medical Cost Trend, cost of care process for plan and mitigation initiatives; and reviews financial statements, reserve development and financial analytics.
  • Partners with pricing actuaries to ensure that premium reimbursement is adequate to cover medical trends, administrative expenses and profit. 
  • Reviews, analyzes, and presents financial results to health plan and line of business leadership as well as the board of directors.
  • Provides decision support for health plan leadership team for operational and business goals. 
  • Directs health )
  • Achieves Medical Cost, MLR and operational income targets set in forecasts; ensures that provider network contracting obtains optimal financial arrangements; co-develops the setting of Cost of Care (CoC) targets and is responsible for CoC execution.
  • Directly interfaces with regulatory and audit personnel and technical consultants as required to ensure fiscal accountability.

Qualifications

  • Requires a BS/BA in Finance, Business Administration, or Accounting; 8-10 years of progressive financial experience with strategic and tactical planning, medical trend or business analytics, budgeting/forecasting, and accounting or financial reporting within a health insurance or managed care environment; experience with complex business environments and highly regulated situations; or any combination of education and experience, which would provide an equivalent background.
  • MBA 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.


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. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

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