Job Information
Elevance Health Manager II GBD Special Programs (Provider Audit) in NASHVILLE, Tennessee
Location: Indianapolis, IN, Tampa FL, Grand Prairie TX, Nashville TN, Richmond VA
Hours: M – F Standard Working hours
Travel: Hybrid (1-2 days onsite per week)
Position Overview:
The Manager II of GBD Special Programs is responsible for management and oversight of multi state program operations and will support the overall strategic approach of the LTSS Center of Excellence. The position is responsible for the development, implementation, and coordination of comprehensive provider auditing for effective oversight, monitoring, and quality improvement of LTSS service providers and vendors.
How You Will Make an Impact:
Directs and oversees program operations in support of corporate and health plan management specific to provider auditing functions and fiscal intermediary oversight.
Directs and collaborates with functional managers to develop and implement the steps necessary to manage program operations across all LTSS markets.
Implements provider auditing and oversight practices in new LTSS markets.
Leads policy/process development and ensuring adherence to contractual and federal requirements specific to LTSS providers in collaboration with necessary teams.
Participates in cross-functional workgroups created to maintain and develop program.
Evaluates program operations to improve efficiency of operations, financial return, customer service, and provider engagement.
Develops, communicates, and monitors program schedule, budget, and resources plan.
Manages resource utilization to ensure appropriate delivery of care to members and adequate coverage for departmental tasks and job responsibilities.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Required Qualifications:
- Requires a BA/BS and minimum of 6 years’ experience, including prior management experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Experience in self-directed Healthcare programs
Experience in Healthcare provider auditing strongly preferred
Project management experience preferred
Data analytics experience preferred
Change management experience is a plus
Experience leading a team strongly preferred