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Medical
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PS27649 Requisition #

 Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

 

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

 

Manager Oversight Compliance

 Location:  Any CA Anthem Office


Summary: The Manager, Oversight Compliance is responsible for managing clinical auditors of delegated provider organization throughout the state of CA for multiple lines of business.


Primary duties may include, but are not limited to: 

  • Develops and manages favorable working partnerships and relationships with delegated entities, physicians, healthcare service providers, and internal customers to improve the delivery and quality of health care.
  • Manages annual and ad hoc delegation oversight audits, analyses of performance measures, reporting, and development of corrective action plans. 
  • Leads intervention activities to enhance communication and educate.
  • Designs programs and strategies to assist delegated entities in meeting standards and improving quality outcomes. 
  • Develops operations processes and ensures standardization of procedures and documentation.
  • Negotiates with delegated entities and internal constituents as needed.
  • Leads healthcare industry initiatives that involve the standardization and streamlining of regulatory oversight functions. 
  • Provides support for litigation issues surrounding regulatory compliance.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications:
  • BS; 6 years of acute care, utilization management, quality management in a hospital or provider organization that was delegated for HMO services with 3 years of management experience and 3 years of experience in conducting oversight audits of delegated entities and/or ancillary providers; or any combination of education and experience, which would provide an equivalent background. 
  • May require some travel 20%
  • Current unrestricted RN license in applicable state(s) required.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. 
To learn more about our company and apply, please visit us at careers.antheminc.com. 
An Equal Opportunity Employer/Disability/Veteran.

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Supplier Registration Process

Anthem, Inc.'s supplier registration process will automatically enter your information into our prospective supplier database.

Anthem does not do business with persons or entities identified on the General Services Administration's List of Parties Excluded from Federal Programs and the HHS\OIG List of Excluded Individuals\Entities.

Anthem, Inc. Purchase Order Terms

Anthem's standard payment terms are net 50. Payment terms will be calculated from the invoice date, which should also reflect the date goods or services were received.

Anthem also offers various discount options that provide you with the opportunity for early payment and we are also encouraging our suppliers to participate in our electronic funds transfer (EFT) method of payment. The EFT method of payment will improve the efficiency of our payment processes and ensure that you are paid properly and on time.

Anthem, Inc. Supplier Registration Process

*Please Note: To complete the supplier registration process, you will leave antheminc.com and will be directed to the Ariba Network (AN) site. Once there please click on Register as New Supplier to complete the online registration form and follow the on-screen instructions.

Supplier Registration

Anthem, Inc. utilizes the Ariba Network to determine qualified suppliers that meet Anthem’s business need. Prospective suppliers should complete Ariba’s Supplier Registration Process.*

*Please Note: To complete the supplier registration process, you will leave antheminc.com and enter the Ariba Network (AN) site. Once there, please click on 'Register as New Supplier' on the left-hand side of the screen, complete the online registration form and follow the on-screen instructions.

Anthem does not do business with persons or entities identified on the General Services Administration's List of Parties Excluded from Federal Programs and the HHS\OIG List of Excluded Individuals\Entities.

What to expect next after registration

Anthem Inc.'s Procurement department will review your registration and additional materials. If our sourcing needs align with your goods or services, an Anthem Buyer will contact you to discuss next steps and other pertinent details. If there is no current need, your information will remain in our prospective supplier database for one year for processing against future requests.

Supporting Documents

Guidelines for Prospective Suppliers (PDF)

Company Policy and Procedures (PDF)

To obtain a copy of Anthem's Supplier Travel Guidelines, please send an email to TravelPoint@anthem.com.