Staff Vice President – Care Management Whole Health Digital Product Management

Description SHIFT: Day JobSCHEDULE: Full-timeBe 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? The Staff VP of Care Management will be responsible for leading Whole Health Digital Product initiatives including but not limited to Care Management, Clinical integrations, Digital and AI Contact Center integrations, and lead all digital responses to Medical Transitions of Care. The Staff VP will also have direct responsibility for all relevant program development, implementation and monitoring in accordance with business needs and State and/or Federal mandates. Additionally, the leader will strategically recommend, develop, and implement initiatives and evaluate outcomes, objectives, policies and procedures related to care management performance and quality improvement, and coordinate services with other departments. The leader will have the responsibility for the strategic integration of clinical initiatives using CM resources. The Staff VP will be serve as a subject matter expert in Care Management to business leaders and stakeholders throughout the organization and provide strategic insights including the use of predictive analytical insights. The Staff VP will be a leader for strategy development that includes staff models with finance and other line of business partners. This position reports to the CTO of Whole Health Advocacy & Provider Engagement Platforms. Duties/ResponsibilitiesProvides oversight of and leadership with minimal guidance to Whole Health Care Management teams, including:

Creating a high performing team

Assisting with budget planning, preparation, and adherence.

Driving initiatives and activities to reduce preventable admissions and readmissions across targeted lines of business

Collaborating with other departments to improve health outcomes and quality measure performance

Continuously improves effectiveness and efficiency of processes and programs, including leveraging new technology, improving predictive models, etc.

Providing information and knowledge to team, including access to internal and external resources that are helpful towards achieving organizational and personal development goals

Develops, implements, and monitors new care management programs relative to applicable lines of business and any product/benefit change

Establishes a measured change management and all additions of Transitions of Care.

Coordinates and advises other stakeholders and business owners of Care Management initiatives

Works as a liaison with external organizations to assure lines of communication are in place for member engagement and communicates directly with families, physicians and community providers as needed.

Participates and represents Care Management on business implementation of new products, various committees, and policy workgroups.

Responsible for monitoring all work product to ensure it is in compliance with all State and/or Federal mandates

Other tasks as assigned

Core CompetenciesStrong program and project management skills

Strong understanding of patient engagement and care management programs; Understand the analytical methods related to measuring the outcomes and effectiveness of such programs. 

Proven track record and experience interfacing with external key business stakeholders/partners to achieve performance and/or clinical quality objectives

10+ years progressive, related business management experience in a high-impact role, with a track record of success leading regional or national operations of managed care and/or healthcare services.

Prior experience overseeing a medical management/clinical services organization desired, with a track record of creating new strategies that support new consumer care management

Strong understanding of the employer, government, and commercial insurance industry, including value-based risk models

Effectively meet and exceed practice/provider needs; build productive relationships with physicians, practice leadership, and take responsibility for practice loyalty and success

Demonstrate interpersonal/verbal communication skills

Strong consultation and influencing skills

Ability to multi-task and work in a fast-paced environment with changing priorities

Experience activating a lean start up within a fortune 500 healthcare payer or provider organization

Demonstrated experience in technology breadth and depth in AI, data, mobile experiences, and building distributed scalable platforms

Minimum QualificationsBachelor's Degree

Experience as a senior leader with Health Care Plan Programs or Companies

Demonstrated strategic thinking, process improvement, innovative thinking and team management expertise

Demonstrated experience in the usage of data to guide decision making

Preferred QualificationsRN or master’s degree in a Health-related field

Experience in Health Plan or Provider-based Care Management

Qualifications Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 15 years of leadership experience in programming environment; or any combination of education and experience, which would provide an equivalent background required.Experience as a senior leader with Health Care Plan Programs or Companies

Demonstrated experience in the usage of data to guide decision making

Skills, Knowledge & CapabilitiesRN or master’s degree in a Health-related field

Demonstrated strategic thinking, process improvement, innovative thinking and team management expertise

Experience in Health Plan or Provider-based Care Management

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 ability@icareerhelp.com for assistance.REQNUMBER: PS71452-US