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Contract and Compliance Manager - Idaho

  • Job Family: Business Support
  • Type: Full time
  • Date Posted:
  • Req #: JR18977

Location:

  • ID, Meridian

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Description

Join the newly created partnership to be the next Managed Care Organization for the Idaho Department of Health and Welfare! The Idaho Behavioral Health Collaborative recognizes that health care is local. The Collaborative combines national expertise with local knowledge. Beacon Health Options, a member of the Elevance Health family of companies, brings the strength, expertise, and best practices of a leading national behavioral health leader. Our local partners, include Blue Cross Idaho (BCI), BPA Health, and the Idaho Crisis & Suicide Hotline (ICSH) complete that expertise with trusted relationships, local decision-making and flexibility. The four organizations have a combined 154 years of expertise, with almost 120 in in the state of Idaho, serving individuals with behavioral health conditions ranging from mild-to-moderate to chronic and complex.

  • Beacon Health Options  brings the strength, expertise and best practices of one of the nation’s leading behavioral health service organizations
  • Blue Cross of Idaho  has strong relationships with behavioral health providers coupled with its strong community presence and local grassroots partnerships throughout Idaho
  • BPA Health , Idaho’s leading behavioral health administrator, completes that expertise with trusted relationships, local decision-making and flexibility.
  • Idaho Suicide Prevention Hotline  provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources for residents of Idaho.

 
This position will serve as a key leader of the Idaho Behavioral Health Collaborative, based in Boise, Idaho. Notice of contract award is expected in October 2022. In anticipation of that award, we are recruiting top talent in effort to have contingency hires offered with starting dates in late October 2022. 


The Contract and Compliance Manager will be responsible for P&L and operational management for a market in a large, highly complex state with multiple regional areas.  Along with State Plan President, establishes business plan, objectives, standards, and policies for Health Plan in accordance with applicable regulatory requirements and State Health Plan business plans, as related to specific contractual programs or obligations.  

Primary duties may include, but are not limited to:  

  • Responsible for some or all local marketing and community relations, network development, provider partnerships, provider relations, medical management, case management and quality management programs, performance management/improvement, budgets, complaints and appeals, regulatory and contractual compliance, financials, and reporting. 
  • Works closely with local governments, regulators, oversight boards, and providers to resolve complex financial, legal, or politically sensitive issues. 
  • Develops short and long term marketing and retention strategies, network strategies and business objectives and lead business initiatives to ensure members, network providers, and community partners successfully participate. 
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports. 

Position Requirements:

  • Must be local to Boise/Meridian
  • Requires a BA/BS in a related field and minimum of 10 years relevant experience including in-depth experience in the HMO/healthcare field, comprehensive knowledge of managed care delivery systems, quality of care initiatives, costs of care initiatives, contracting, servicing and operational aspects of a Health Plan; or any combination of education and experience, which would provide an equivalent background. 
  • Master’s degree preferred. 
  • Travel may be required.


 


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

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?

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 Elevance Health. 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 Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health 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.ElevanceHealthinc.com. Elevance Health 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.

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