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Staff Vice President Medicare Claims Operations

  • Job Family: Business Support
  • Type: Full time
  • Date Posted:
  • Req #: JR21665

Location:

  • IN, Indianapolis

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Description

NGS Staff Vice President is responsible for leading and directing NGS operations. Responsible for day-to-day operations and the long-term success of the organization including claims processing, call center, appeals and grievances, audit and reimbursement, outreach and education, provider enrollment, and overpayments. This position will report to the NGS Vice President and Chief Operating Officer. 

Primary duties may include, but are not limited to:

  • Oversees daily management of operational activities and facilitates end-to-end resolution between the business, subcontractors, and NGS shared services.  Develops, implements, and manages a strategic plan for operations and execution; resolves issues and provides guidance.
  • Ensures that departmental decisions and project plans for staffing, system enhancements and operational efficiencies are in line with the organizations business plan and vision.
  • Develops, implements, and monitors processes, policies and procedures to optimize work processes, maximize efficiencies and ensure compliance with corporate, state and regulatory requirements such as FAR guidelines and SOW requirements.
  • Cultivates and drives high performing teams to execute and manage operations.
  • Establishes, implements, and communicates the strategic direction of the organizations operations division in order to upturn proficiency, productivity, and efficiency.
  • Responsible for budget oversight and monitoring, tracking and evaluating factors that could impact achievement of fiscal and performance goals.
  • Ability to communicate effectively with customers and executive leadership with regard to organizational performance.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports and the greater operations organization.
  • Identifies, recommends, and implements new processes, technologies, and systems to improve and streamline organizational processes

Requirements

  • Requires a BA/BS and a minimum of 10 years of experience with a minimum of 5 years of professional/leadership experience within claims processing and/or call center operations environment; or any combination of education and experience which would provide an equivalent background. 
  • At least 10 years of industry-related experience including three years in upper management required.
  • Medicare knowledge and experience preferred.
  • PMP certification preferred.

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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