Anthem, Inc. Solutions Management Director - Cardio & Sleep AIM Specialty Health in Miami, Florida
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Be part of an extraordinary team
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
AIM Specialty Health is a benefit-management leader in Illinois and a proud member of Anthem's family of companies. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.
AIM's Core Diagnostic Products Team is looking for a Solutions Management Director to join its team. S/he will be responsible for Sleep and Cardiology Benefit Management Programs and Solutions development.
[This position can work remotely from any US location]
Responsible for leading the planning and implementation of products and services for the most complex, diverse lines of business enterprise wide. Serves as the single point of contact and subject matter expert on all aspects of planning, implementing and managing day to day operational, technical and business partner interactions for existing programs and works together with Product Development to consult on enhancements to existing products and development of new clinical solutions based on department analytics.
Primary duties may include, but are not limited to: Provides consultation and advice to business partners regarding benefits of products and analytics. Explains timelines and measures of success for implementing these products. Coordinates with the Physician Liaison regarding clinical issues related to clinical measure implementation or customization by line of business and communicates changes to Product Development for consideration in product performance and financial analyses. Schedules and coordinates implementation of contracted products and services for assigned business partners. Coordinates data requirements, production schedules and deliverables with the business partner. Oversees all business partner specifications and/or modifications for contracted products and services. Provides business partners with the resources, training and services necessary to effectively utilize the products that provides. Analyzes business partner data for QA and identification of opportunities for business partners to utilize products and services to improve plan performance. Maintains expert knowledge of current clinical measures and future clinical measure development plans, communicates this information to business partners, assists in the selection of clinical measures to be utilized in pilot and full rollout of products and services, and guides business partners in continually reviewing and updating clinical measure sets. Maintains expert knowledge of all current systems, products and services and basic understanding of future system and product development plans to allow appropriate level of communication with business partner. Leads department projects and mentors solutions management staff. Provides leadership to managers and consultants. Serves as subject matter expert for the department. Directors typically support business strategies through an integrated portfolio of programs, projects and initiatives.
Requires a BA/BS and minimum of 8 years experience in a related field, including minimum of 3 years Solutions Management experience; or any combination of education and experience, which would provide an equivalent background
Highly preferred skills and experience:
-Experience with Clinical workflow products or programs
-Healthcare technology experience
-Understanding of how a Health plan configures their data
-Project Management Expertise
-Experience with how providers interact with a Prior Auth / UM tool such as AIM products
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 Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact email@example.com for assistance.