Government Benefits State Operations Director- Mid Atlantic
Elevance Health

Job Info

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Government Benefits State Operations Director-Mid Atlantic

*** Norfolk VA or Richmond VA

Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of our Norfolk, VA or Richmond, VA Elevance Health PulsePoint location.

The Government Benefits State Operations Director is responsible for operations functions, including coordination between internal departments, ensuring the appropriate strategy, tactics and processes are in place to affect solid organizational operations and oversight.

How you will make an impact:

Primary duties may include, but are not limited to:

• Resolves programmatic challenges related to operations including member issues, provider claims issues, contract configuration issues, etc.
• Serves as liaison to Health Plan support services, which could include: Claims, Enrollment, NCC, PDM/PDQ, configuration; Quality, Regulatory Compliance, IT, Reimbursement policy, etc.
• Identifies opportunities for Operational Excellence and works to create seamless processes between shared services and the Health Plan.
• Develops and implements key operational indicators to be used for monitoring and analysis of the Health Plan operations.
• Serves as a liaison with state regulatory agencies when appropriate.

Minimum Requirements:

Requires a BA/BS in Business, Healthcare Administration or related field and minimum of 10 years experience, including minimum of 8 years in-depth experience in managed care operations; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Masters degree preferred.
• Six Sigma Black Belt preferred.

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