Elevance Health - Atlanta, GA
posted 1 day ago
About the position
The Manager of Government Business Other Revenue Programs is responsible for ensuring the overall success of Medicare and Medicaid 'Other' Revenue programs, aimed at enhancing revenue from the Center for Medicare and Medicaid Services (CMS) and State Medicaid Agencies. This role involves managing day-to-day operations, developing metrics, policies, and procedures to support deliverables and validate program ROI, while ensuring compliance with CMS program requirements. The manager will also serve as an internal Subject Matter Expert (SME) for End-Stage-Renal-Disease and Medicare Secondary Payer end-to-end programs, and will be responsible for hiring, training, coaching, counseling, and evaluating the performance of direct reports.
Responsibilities
- Manage the day-to-day operations of 'Other' revenue programs in Medicare Advantage and Medicaid.
- Develop metrics, policies, and procedures in support of required deliverables and validation of programs ROI.
- Ensure compliance with CMS program requirements.
- Become an internal SME for End-Stage-Renal-Disease and Medicare Secondary Payer end-to-end programs.
- Hire, train, coach, counsel, and evaluate performance of direct reports.
Requirements
- BA/BS in a related field.
- Minimum of 5 years of management experience in a managed care setting.
- Extensive risk adjustment experience with a focus on CMS audit experience.
Nice-to-haves
- Knowledge of Government programs (Medicare & Medicaid) strongly preferred.
- Experience within a Government Programs plan preferred.
- Experience with programs such as: ESRD, MSP, SSI conversions, Part A/Part B.
Benefits
- Merit increases.
- Paid holidays.
- Paid Time Off.
- Incentive bonus programs.
- Medical, dental, vision benefits.
- Short and long term disability benefits.
- 401(k) + match.
- Stock purchase plan.
- Life insurance.
- Wellness programs.
- Financial education resources.
