Anthem, Inc NGS SME Lead-PS14332 in Portland, Maine

NGS SME Lead-PS14332

Location: Indianapolis, Indiana, United States

Field: Education & Training

Requisition #: PS14332

Post Date: Dec 04, 2018

Your Talent. Our Vision. At National Government Services (NGS) , an independent subsidiary of Anthem, Inc. and one of the largest Medicare contractors in the country,it’s a powerful combination. It’s 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.

The NGS SME Lead will be responsible for providing quality audits for Audit & Reimbursement, training and oversight of the quality process, as well as Subject Matter Expertise for Audit & Reimbursement and content documentation for training. Primary duties may include, but are not limited to:

  • Provides complex, in-depth knowledge and expertise and serves as coach and mentor to NGS SME I, NGS SME II and content analysts.

  • Provides leadership in problem solving and decision making relative to complex issues and questions in the development of training and content products and solutions.

  • Performs quality audits of work performed by Audit & Reimbursement.

  • Researches, reviews, analyzes and interprets complex Medicare policy Audit & Reimbursement.

  • Analyzes needs and gaps, identifies solutions and best practices and provides consultation on Medicare training and content.

  • Reviews and provides feedback on Standard Operating Procedures (SOPs) to ensure accuracy and completeness.

  • Reviews feedback and evaluates training and content, recommends and supports implementation of improvements.

  • Assists leadership team with project planning and implementation.

  • Leads and provides oversight on projects and initiatives involving multiple associates.

  • Reviews Medicare program material, monitors media outlets, analyzes information, extrapolates impacts and communicates to others.

  • Understands Medicare specific processes, technologies and key drivers of performance in order to integrate them into products and solutions.

This position must work for the Indianapolis, IN; Harrisburg, PA or South Portland, ME Offices.

  • Requires BA/BS degree in business, learning, education, instructional design or project management, 7 years of experience; or any combination of education and experience, which would provide an equivalent background.

  • Experience in Medicare/Audit & Reimbursement.

  • Proficient in MS Excel.

  • Experience with Centers for Medicare & Medicaid Services (CMS) is desired.

The applicant and incumbent in this position fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc 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.