http://www.amerigroup-jobs.com/feeds/administrative-fellowship-programs-at-amerigroup-jobs/ Custom RSS Feed for administrative-fellowship-programs-at-amerigroup-jobs Sat, 18 May 2013 20:45:19 GMT en-us /sites/amerigroup/images/banner.gif http://www.amerigroup-jobs.com/feeds/administrative-fellowship-programs-at-amerigroup-jobs/ 720
Job ID 2012-21352 # Positions 1
Location US-TN-Nashville
Search Category Health Care Operations
Type Regular Full-Time (30+ hours) Posted Date 12/3/2012
Additional Locations ..

More information about this job:
Summary:

Responsible for developing and expanding AMERIGROUP physician, physician group, IPA, hospital and ancillary networks. Responsible for negotiating reimbursement methodologies and contract language in existing and expansion markets. Ensure that all contracts meet AMERIGROUP standards, including feasibility of administration and reimbursement parameters. Support in the development of external recruitment provider materials.

Responsibilities:

1. Coordinate the management and growth of the hospital relations program or ancillary network that is in line with the health plan’s goals.

2. Coordinate with various departments to effectively implement and manage hospital relations or ancillary network development strategy.

3. Monitor hospital or ancillary network concerns, issues, and business opportunities and work with other functional areas of the Health Plan and Home Office regarding resolutions.

4. Management of Advocacy/Education Process with hospitals and ancillary networks including:
- Financial/Operational analysis regarding contract structure;
- Right-sizing of the ancillary provider network with providers that provide cost effective, quality services to AMERIGROUP members at the least administrative cost that meet contract requirements;
- Develop and implement processes/systems that ensure that hospitals and ancillary providers’ claims are paid accurately, timely, and on first submission;
- Coordination of all processes pertaining to contract implementation/maintenance.
- Coordination of market expansion initiatives;
- Negotiation of financial terms and contract language.

5. Identify quality-based, cost efficient processes and lead efforts to gain acceptance and ensure effective implementation.

6. Serve as key contact for targeted hospitals and other providers to ensure effective communication and response mechanisms.

7. Monitor national trends and local Health Plan market trends relative to Provider contracting, reimbursement, and service, make recommendations to modify current processes and assist to implement changes, when necessary.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s Degree in business administration, healthcare administration, or a related field or equivalent experience.

Years and Type of Experience Required:

Required:
- 5 years experience in a healthcare environment, preferably managed care with at least 1 year of leadership/management experience.
- Specific experience in network development, analysis, and contracting.
- Strong understanding of the healthcare industry, managed care, and provider financing.
- Experience contracting with large, complex provider organizations.
- Documented success in provider contracting, recruitment, retention, and service.

Preferred:
- Knowledge of Medicaid reimbursement and methodologies.

Specific Technical Skills

Required:
- Knowledge of hospital organizational structure including integrated delivery system, PHO’s IPA and Group Practices.
- Computational and analytical skills related to Provider contracting and healthcare cost management.
- Excellent computer skills including MS Office and Access.

Certifications or Licensures

Required:
- Must have a valid driver’s license and access to a motor vehicle.

Other:

Required:
- Excellent verbal and written communication skills.
- Excellent management skills.
- Strong analytical abilities.
- Proven project management skills with a demonstrated ability to manage multiple projects and meet deadlines.
- Appreciation of cultural diversity and sensitivity toward target population.
- Respect for and ability to work well with all levels of the organization and with the Provider Community.
- Ability to establish strategic vision, set expectations and provide clear direction to individuals or departments being managed.
- Understanding of the legal and regulatory environment relative to Provider Relations.

PHYSICAL REQUIREMENTS
- Must be able to operate a computer.
- Must be able to operate a telephone.
- Must be able to travel on common carrier and adhere to AMERIGROUP’s travel policies.

ermHO
]]>Fri, 03 May 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Nashville-Manager-Contracting-Plan-Job-TN-37201/2304825/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Nashville-Manager-Contracting-Plan-Job-TN-37201/2304825/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22834 # Positions 1
Location US-NATIONWIDE
Search Category Legal
Type Regular Full-Time (30+ hours) Posted Date 5/13/2013
Additional Locations ..

More information about this job:
Summary:

The position is responsible for the regulatory compliance activities of AMERIGROUP’s Medicare Advantage(“MA”), Special Needs Plan (“SNP”), and Part D Prescription Drug (“PD”) product offerings The Compliance Analyst focuses on AMERIGROUP and its delegated vendor’s, first tier, and downstream related entities compliance with the regulatory/contractual obligations of the Centers for Medicare and Medicaid Services (“CMS”) and multiple state regulatory bodies, as well as oversight of the MAPD and SNP product requirements and deliverables.

Responsibilities:

1. Support the oversight of the federal and state regulatory compliance programs and activities for AMERIGROUP’s SNP and MA-PD products:
- Provide management with information for strategic planning.
- AMERIGROUP liaison with CMS and applicable state agencies, serving as “account manager.”
- Maintain productive working relationships with key regulators charged with AMERIGROUP contract administration that leads to a collaboration benefiting company operations and activity.
- Subject matter expert on Medicare Advantage and Part D requirements and programs.

2. Assess, communicate and ensure associate understanding of federal regulations, legislation and CMS Operational Manuals and Memorandums that impact business activity and operations.

3. Maintain resource tools identifying SNP and MA-PD requirements for internal education, and compliance assessments.

4. Conduct onsite and/or desktop audits of all delegated vendors and ensure compliance with training requirements for all applicable contractors.

5. Manage schedule of both internal areas and delegated vendors, ensure all corrective actions are implemented, and ensure all audits are conducted on time and thoroughly.

6. Participate in AMERIGROUP and vendor preparations for multiple SNP and MA-PD performance assessments, CMS audits, and Program Integrity Audits:
- Assist in preparing AMERIGROUP and vendor operational leads for targeted audit activity.
- Coordinate and organize desk review submissions and on-site audit materials.
- Participate in on-site assessment and audit activity.
- Facilitate development of corrective action plans (“CAPs”) and oversee CAP implementation.
- Interact with audit and enforcement agencies to correct deficiencies and minimize CMS administrative actions and sanction activity. Manage submissions of regulatory deliverables and monitor CMS management reports.

7. Responsible for the review and submission of CMS Part C and D reporting to ensure compliance with CMS requirements.

8. Manage regulatory filings and approvals of marketing/advertising materials, member correspondence and outreach programs through CMS HPMS system.
- Review collateral materials via Collateral Material Approval Process;
- Negotiate approvals by CMS and state agency liaisons.

9. Participate in SNP and MA-PD product expansion and new market activities via project management of regulatory document preparation, submission and federal/state approvals.
- Define regulatory requirements and maintain project plan and document tracking system.
- Identify/attain agreement on business owner accountability for deliverables.
- Guide project team members to ensure project deliverables are met, disconnects identified and resolutions achieved.
- Department implementation lead. 10. Other duties as assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- High School Diploma with 3 years relevant work experience.

Preferred:
- Bachelor’s Degree.

Years and Type of Experience Required:

Required:
- Minimum of 3 years experience working in regulatory operations of a Medicare Advantage (Medicare+Choice) plan
- Knowledge of federal HMO and Medicare Managed care regulations

Specific Technical Skills

Required:
- Intermediate level Microsoft Office Suite skills.
- Specifically Word and Excel.

Other:

Required:
- Strong analytical and organizational skills.
- Strong verbal and written communication skills.
- Ability to analyze, interpret, and summarize contracts, regulations, policies/procedures, reports and legal documents.
- Ability to respond to questions/concern from internal customers and regulatory agencies present company position in understandable and unambiguous manner.
- Ability to identify root cause, recommend options and implement/negotiate appropriate solutions.
- Ability to effectively set priorities and meet commitments.
- Ability to work under pressure and within strict time frames.
- Comfortable interfacing at all levels of the organization.
- Appreciation of cultural diversity and sensitivity towards target population.

PHYSICAL REQUIREMENTS
- Must be able to operate a computer and a telephone.
- Must be able to access/operate filing systems.
- Must be able to conduct, facilitate, and actively participate in meetings.
- Periodic travel required - must be able to travel on common carrier.

ermCorp
]]>Mon, 13 May 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Compliance-Analyst-Medicare-%28position-located-in-Virginia-Beach%29-Job/2594751/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Compliance-Analyst-Medicare-%28position-located-in-Virginia-Beach%29-Job/2594751/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22785 # Positions 1
Location US-TX-Houston
Search Category Medical Director
Type Regular Full-Time (30+ hours) Posted Date 5/7/2013
Additional Locations ..

More information about this job:
Summary:

AMERIGROUP CORPORATION

MEDICAL DIRECTOR BEHAVORIAL HEALTH Houston

Amerigroup is a Fortune 500 company serving approximately 2 million members in 14 states. Nationwide, we serve one out of every 35 Medicaid recipients and one out of every 25 kids covered by CHIP.

We improve access to quality health care for our members while lowering costs for taxpayers. We coordinate services for individuals in publicly funded health care programs.

Amerigroup accepts all eligible people regardless of age, sex, race or disability.

Our product offerings do not utilize any individual underwriting nor deny coverage due to pre-existing medical conditions. Amerigroup is dedicated to offering real solutions that improve health care access and quality for its members, while proactively working to reduce the overall cost of care to taxpayers.

JOB SUMMARY

Oversees all behavioral health care for AMERIGROUP products and services in Houston. Oversees the health care needs of the membership and serves as the principal behavioral health manager and policy advisor to the company and health plan CEO or COO. Is accountable for and provides professional leadership and direction to the utilization/cost management and clinical quality management functions. Works collaboratively with other plan functions that interface with behavioral health management such as medical management, provider relations, member services, benefits and claims management, etc. Assists in short and long range program planning, total quality management (quality improvement) and external relationships. Works with Corporate Health and Medical Affairs for support, assistance and direction in overall behavioral health management effectiveness. Reports all issues of clinical quality management to the health plan CEO, COO, the Board and the Chief Medical Officer (CMO) of AMERIGROUP Corporation. Collaborates with the CMO, the National Medical Director of Behavioral Health and other health plan medical directors on national medical policies and carries out national medical policies at the health plan in collaboration with the health plan CEO or COO

Responsibilities:

1. Assists in managing medical costs and assuring appropriate health care delivery for Amerigroup health plans, products and services.

2. Provides guidance, support and leadership for utilization management activities.

3. Supports Medical Director(s) in all aspects of utilization, quality and network management.

4. Provides support to nurses and clinical leaders in pre-authorization, concurrent and retrospective review decisions, case management and disease management decisions.

5. Assists Medical Directors and/or National Medical Directors with medical policy; participates in policy review, reviews trends and makes recommendations; may plan, organize and/or direct medical services programs, consisting of all primary and specialty services for in-patient, out-patient, preventive and wellness programs.

6. Assists in the design and implementation of corrective action plans to address issues and improve plan and network managed care performance.

7. Supports URAC, AHCA and NCQA qualification activities. Prepare for site visits and responds to accrediting and regulatory agency feedback.

8. Participates in risk management, claims adjudication, utilization management, catastrophic case review, education and outreach programs, HEDIS reporting, credentialing, peer to peer review, appeals review, denials, etc.

9. Participates in the development of strategic planning for existing and expanding business. Recommends changes in program content in concurrence with changing markets and technologies.

10. Other duties as assigned or requested.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:

Medical Doctor with specialization and board certification in Psychiatry. - Continuing education to remain current in behavioral health and management areas. - Any equivalent combination of education and experience. Years and Type of Experience Required: Required: - Five years of clinical experience in the practice of medicine, two of which have been in medical and/or health administration. - Three to five years of management and /or clinical experience in a managed care environment. Certifications or Licensure Required: •Board Certified in Psychiatry. - Must be licensed in the state of Texas as a Doctor of Medicine or be able to achieve such licensure upon hire- Active license to practice medicine without restriction issued by the State Board of Licensure or the State Board of Examiners. Preferred: - Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management desired but not required. Other Required: - Management skills to meet the organizational goals. - Must possess excellent communications skills to interface with providers, staff, and management. - Knowledge of behavioral health, quality improvement and UM practices in a managed care environment. - Knowledge of regulatory and accreditation agencies and requirements. - Able to manage multiple priorities and deadlines in an expedient and decisive manner. - Able to manage difficult peer situations arising from medical care review. - Appreciation of cultural diversity and sensitivity towards target population. PHYSICAL REQUIREMENTS: - Must be able to operate a computer. - Must be able to operate a telephone. - Must be able to travel on common carriers and to adhere to AMERIGROUP’s travel policies. - Must be able to operate a motor vehicle. - Must be able to conduct and participate in meetings

Preferred:
- Board Certification in Addictionology or substantial clinical experience in substance use disorders OR Child Psychiarty
- Masters in Public Health, MBA or MA.
- Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management

Language Skills

Required:
- English

Functional Competencies
- Think creatively, Innovative
- Understanding of financial and business acumen
- Collaborative team player; active listening skills
- Excellent verbal and written communication skills and ability to build and sustain strong working relationships
- Organizational skills and demonstrated ability to multitask and execute
- Strong people leadership and influencing skills
- Strong project management skills; ability to drive programs and lead change
- Knowledge of medical, quality improvement and utilization management practices in a managed care environment
- Knowledge of regulatory and accreditation agencies and requirements
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.
- Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.
- Ability to read, comprehend and interpret complex information and trends to provide accurate and appropriate information to business partners and/or customers.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.

SCOPE INFORMATION

# Direct Reports: As assigned

# Indirect Reports: As assigned

Budgetary $ Responsibility: As assigned

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures

CB1

ermEL
]]>Tue, 07 May 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Houston-Medical-Director-Behavorial-Health-Job-TX-77001/2585343/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Houston-Medical-Director-Behavorial-Health-Job-TX-77001/2585343/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22843 # Positions 1
Location US-VA-Virginia Beach
Search Category Communications
Type Regular Full-Time (30+ hours) Posted Date 5/14/2013
Additional Locations ..

More information about this job:
Summary:

Responsible for ensuring the overall quality of designated Proposal Management projects with elements such as researching, writing and organizing documents in support of Amerigroup’s business development and proposal efforts. Responsible for on-boarding, training and managing associate and consultant writers, editors and compliance reviewers and copy editors. In this role, tactical execution is necessary to prepare well-written responses/documents that comply with Requests For Proposal (RFPs) and Requests for Information (RFIs) from start to finish, working with subject matter experts (SMEs) to gather information and provide high-quality proposal responses. Serve as a leader within the department (to other writers and production team members) and outside the department to executives, associates and external consultants and vendors.

Responsibilities:

1. Responsible for developing, creating, reviewing, editing and managing designated RFPs. Develop training materials to efficiently educate writers on the Amerigroup process.

2. Create or refine proposals, an ability to cite proposal portions that require clarification and supporting proof/data points, verifying and amending content/data gaps, confirming strategy/product alignment.

3. Supervise the processes and procedures of designated RFPs. Schedule deliverables and ensure that consultants are available in the needed timeframes.

4. Responsible for the on-boarding of new consultant writers and editors to include pre-screen interviews, assessing strengths and areas of writing expertise and asissitng new consultants through the onboarding process.

5. Coordinate and schedule (including working with appropriate presenters) training sessions as needed for new associate and/or consultant training so that writers/editors/reviewers have an understanding of the Amerigroup proposal process.

6. Perform relevant segments of aforementioned training (Corporate background and experience, process, roles and responsibilities, etc).

7. Provide Leadership to the department and participate in constructive assistance to other writers including consultants; Assist with the on-going. management/administration of proposal writers and editors (associates and consultants) in the Amerigroup database.

8. Conduct research to obtain information for proposal content development. Prepare presentation documents with content and direction provided by others.

9. Lead kick-off, strategy, and debrief meetings respective to writing assignments.

10. Develop responses to complex RFP/RFI requirements by working with identified SMEs to determine and develop responses for specific content for assigned sections.

11. Write assigned sections ensuring compliance with the RFP/RFI requirements. Proofread proposals to apply company standards for accuracy, quality writing, and marketing focus. Revise sections as directed.

12. Conceptualize supporting graphics for documents to illustrate and simplify concepts; work with assigned graphic designers to produce final versions of illustrations for insertion into the document.

13. Lead the online market analysis and proposal content database maintenance process.

14. Perform other duties as assigned or requested.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in English, Marketing, Journalism, Communications or Health Systems Administration with twice the required management and writing experience listed below.

Preferred:
- Master’s degree in English, Marketing, Journalism, Communications or Health Systems Administration.

Years and Type of Experience Required:

Required:
- Minimum of five (5) years experience with proposal-development writing and project management on large and complex RFP responses.
- Minimum of three (3) years managing and training internal or consultant team members, specifically in the areas of writing, editing, RFP review, or project management.
- Demonstrated success in proposal writing.
- Excellent skills in writing clear and focused copy that meets strategy and objectives.
- Demonstrated success in managing projects from conception to execution.

Preferred:
- Minimum of seven (7) years experience with proposal-development writing and project management on large and complex RFP responses.
- Technical writing or proposal development in the health-insurance field.
- Working knowledge of Medicaid or other public-sector healthcare program.
- Excellent project management and planning skills.
- Working knowledge of publication production tools.
- Experience as a proposal evaluator.

Certifications or Licensures

Required:
- N/A

Preferred:
- Association of Proposal Management Professionals (APMP) Foundation, Practitioner, or Professional Accreditation.

Functional Competencies
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks.
- Working knowledge in a windows environment, in particular with Word, PowerPoint, and Excel, to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize, and edit data.
- Preferred working knowledge of publication production tools.
- Ability to use software to conduct data analysis, reporting, and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.
- Ability to read, comprehend and interpret complex information to provide accurate and appropriate information to business partner or customer.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.
- Ability to understand when to escalate erroneous/inconsistent information discovered in resources to appropriate level of management for review.

SCOPE INFORMATION

# Direct Reports: 0

# Indirect Reports: 10-15

Budgetary $ Responsibility: N/A

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.


]]>Tue, 14 May 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Virginia-Beach-Manager-Proposal-Writing-&-Editing-Job-VA-23450/2597180/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Virginia-Beach-Manager-Proposal-Writing-&-Editing-Job-VA-23450/2597180/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2012-20924 # Positions 1
Location US-KS-Overland Park
Search Category Medical Director
Type Regular Part-Time (20-29 hours) Posted Date 10/12/2012
Additional Locations ..

More information about this job:
Summary:

Amerigroup is a Fortune 500 company serving approximately 2 million members in 14 states. Nationwide, we serve one out of every 35 Medicaid recipients and one out of every 25 kids covered by CHIP.

We improve access to quality health care for our members while lowering costs for taxpayers. We coordinate services for individuals in publicly funded health care programs.

Amerigroup accepts all eligible people regardless of age, sex, race or disability.

Our product offerings do not utilize any individual underwriting nor deny coverage due to pre-existing medical conditions. Amerigroup is dedicated to offering real solutions that improve health care access and quality for its members, while proactively working to reduce the overall cost of care to taxpayers.

Responsibilities:

Provides support and leadership around behavioral health care for AMERIGROUP products and services in Kansas.. Provides professional leadership and direction to the utilization/cost management and clinical quality management functions. Works collaboratively with other plan functions that interface with behavioral health management such as medical management, provider relations, member services, benefits and claims management, etc. Assists in short and long range program planning, total quality management (quality improvement) and external relationships. Works with Corporate Health and Medical Affairs for support, assistance and direction in overall behavioral health management effectiveness.. Collaborates with the CMO, the National Medical Director of Behavioral Health and other health plan medical directors on national medical policies and carries out national medical policies at the health plan in collaboration with the health plan CEO or COO.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- MD or DO, with board certification in area of specialty.

Preferred:
- Masters in Public Health, MBA or MA.

Years and Type of Experience Required:

Required:
- Minimum of five years clinical experience with at least two years in medical management/health administration in a managed care environment.

Certifications or Licensures

Required:
- Active license to practice medicine without restriction issued by the State Board of Licensure or the State Board of Osteopathic Examiners. Certified in a recognized medical specialty as recognized by the American Board of Medical Specialists (ABMS).

Preferred:
- Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management

Language Skills

Required:
- English

Functional Competencies
- Think creatively, Innovative
- Understanding of financial and business acumen
- Collaborative team player; active listening skills
- Excellent verbal and written communication skills and ability to build and sustain strong working relationships
- Organizational skills and demonstrated ability to multitask and execute
- Strong people leadership and influencing skills
- Strong project management skills; ability to drive programs and lead change
- Knowledge of medical, quality improvement and utilization management practices in a managed care environment
- Knowledge of regulatory and accreditation agencies and requirements
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.
- Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.
- Ability to read, comprehend and interpret complex information and trends to provide accurate and appropriate information to business partners and/or customers.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.

SCOPE INFORMATION

# Direct Reports: As assigned

# Indirect Reports: As assigned

Budgetary $ Responsibility: As assigned

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

HEC:DW

ermEL
]]>Sun, 28 Apr 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Overland-Park-Medical-Director-Behavorial-Health-Part-Time-Job-KS-66062/2211141/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Overland-Park-Medical-Director-Behavorial-Health-Part-Time-Job-KS-66062/2211141/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22187 # Positions 1
Location US-VA-Virginia Beach
Search Category Health Care Administration
Type Regular Full-Time (30+ hours) Posted Date 3/6/2013
Additional Locations ..

More information about this job:
Summary:

The incumbent will serve as the primary clinical leader for Amerigroup’s dual initiative, and will be responsible for the program development, implementation, and management of Utilization Management, Case Management, Disease Management, Audit, Quality Management, Pharmacy Services, Mental Health, and/or Appeals and Grievances. The ideal candidate incumbent has at least 12 years of leadership experience in Medicaid/Medicare medical management (Nursing or Social Work), with Long Term Support Services (LTSS) and medical Geriatric experience, working in a matrix organization.

Responsibilities:

1. Directs and provides leadership for designing, developing, and implementing the local Plan integrated medical management program to meet the demographic and epidemiological needs of the population serviced.

2. Directs Healthcare Management Program for membership including disease management, case management, and utilization management.

3. Establishes objectives and annual goals in conjunction with the Medical Director to meet objectives established by the Plan CEO/COO and corporate HCMS.

4. Promotes understanding, communication, and coordination of Integrated Medical Management Programs across the health plan.

5. Works with Provider Relations, Quality Management and Health Promotions to develop and implement effective provider communications, quality assurance and member outreach programs.

6. Provides expert consultation to local plan staff on benefits interpretation and utilization and quality management matters.

7. Coordinates on a quarterly basis reporting of quality initiatives to all appropriate plan committees.

8. Ensures support for compliance with National Committee for Quality Assurance (NCQA) and assures compliance with state/and or federal program requirements.

9. Monitors and makes recommendations for oversight of appropriate delegated services.

10. Develops the annual operating and capital budget: ensures that departments stay within budget and accounts for variances.

11. Works collaboratively with key health care professionals toward identification of opportunities for improvement, trend analysis, education and development of appropriate action plans for problems resolution.

12. Other duties as requested or assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelors Degree in a health care field or equivalent experience (equivalent experience equates to 6 years related experience in addition to the required 12 years experience).

Preferred:
- Masters Degree in a health care field, or
- MBA with Health Care concentration.

Years and Type of Experience Required:

Required:
- Minimum of 12 years relevant clinical work experience and at least 7 years of leadership/management experience preferably in a managed care setting , with at least 5 years of clinical experience (post Masters for Behavioral Health).
- Previous experience with NCQA accreditation and HEDIS reporting.

Certifications or Licensures

Required:
- RN, LCSW, LPC

Language Skills

Required:
- English

Functional Competencies
- Proficient in the use of Microsoft Office products, to include Outlook, Word, Excel and PowerPoint.
- Excellent problem solving skills; ability to multi-task and solve complex problems.
- Excellent organizational and analytical skills.

SCOPE INFORMATION

# Direct Reports: 5-30

# Indirect Reports: varies

Budgetary $ Responsibility: As assigned

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

ermHO
]]>Thu, 16 May 2013 02:59:00 GMThttp://www.amerigroup-jobs.com/job/Virginia-Beach-VP-Healthcare-Mgmt-Svcs-Job-VA-23450/2467976/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Virginia-Beach-VP-Healthcare-Mgmt-Svcs-Job-VA-23450/2467976/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22129 # Positions 1
Location US-NATIONWIDE
Search Category Legal
Type Regular Full-Time (30+ hours) Posted Date 2/27/2013
Additional Locations ..

More information about this job:
Summary:

Serve as Counsel for assigned AMERIGROUP subsidiary health plan(s). Handle intake and resolution of legal issues related to regulatory compliance, provider network development and maintenance, provider disputes, regulatory agency disputes, product development and plan expansion, risk management, and regulatory agency contracts for assigned markets. Participate in merger and acquisition activity and new market development activity to support subsidiary plan growth into new state markets, including conducting legal due diligence review of acquisition targets, developing model provider contracts for new markets, participating on new market implementation teams, and handling legal issues related to the assimilation of acquisition targets in to AMERIGROUP, including target provider network assimilation issues. Participate with Plan and Healthcare Delivery Systems (HCDS) business owners, upon request, in contract negotiations, process improvement and other contracting issues. Manage assigned paralegal and administrative staff.

Relocation to Virginia Beach is preferred

Responsibilities:

1. Interact with Regional CEOs, Plan CEOs, COOs and management staff to handle intake and resolution of legal issues identified by assigned Health Plans.

2. Provide support to Health Plans related to regulatory compliance, including interacting with Regulatory Department managers to resolve legal issues identified by the Regulatory Department. Provide support to the Plan regarding regulatory agency disputes.

3. Provide support to assigned health plan(s) and corporate departments focusing on provider network development and maintenance regarding network-wide contracting issues and initiative as well as specific provider contracting initiatives and contract disputes.

4. Support product development and plan expansion initiatives for assigned health plan(s).

5. Review and advise on risk management issues identified by assigned health plan(s).

6. Upon request by Regulatory Department, Government Markets or Health Plan business owners, provide advice regarding agency contracts and amendments to agency contracts, and/or participate in negotiations with agencies to complete agency contracts or amendments.

7. Manage provider contracting request workflow, assign paralegal provider contracting projects to market managers, review and revise paralegal provider contracting work product and supervise paralegal interaction with business owners and business owner requests for project work.

8. Maintain provider contracting tools for assigned existing markets and develop new tools for new markets.

9. Foster and maintain strong working relationships with assigned Health Plans and corporate departments.

10. Participate directly in contract and settlement negotiations with providers and provider counsel, upon the request of Health Plan business owners.

11. Manage litigation related to disputes arising at the Health Plan level. Work directly with outside counsel and the Health Plan to facilitate optimal outcomes to pending or threatened litigation.

12. Assist in maintaining and updating Legal Department policies and procedures related to provider contracting. Identify and assist in effecting provider contracting process improvements.

13. Assist in maintaining paralegal provider contracting quality control and production standards.

14. Conduct ongoing training for provider contracting paralegals and evaluate paralegal performance for assigned markets.

15. Participate in business owner training related to provider contracting initiatives.

16. Develop and draft model contracts, network-wide amendment documents and other contracting projects upon request for assigned markets.

17. Perform contract work related to product development initiatives, service area expansions, new state market expansions and acquisition projects.

18. Conduct and/or supervise, as appropriate, contract due diligence activity related to acquisition projects.

19. Serve on new market implementation teams and address issues related to the assimilation of acquisition targets, including target’s provider network, in to Amerigroup.

20. Perform other duties as assigned or requested.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Juris Doctor (JD) or Legum Baccalaureus (LLB).

Years and Type of Experience Required:

Required:
- Minimum of 7 years of legal experience including provider contracting experience with at least 3 years of leadership/management experience.

Certifications or Licensures

Required:
- Member in good standing of a state bar with eligibility to obtain Virginia Bar in-house counsel status.

Language Skills

Required:
- English

Functional Competencies
- Proficient with various computer programs including Microsoft Word, Outlook, Excel and Access.
- Experience with contract database software.

SCOPE INFORMATION

# Direct Reports: 1+

# Indirect Reports: 1+

Budgetary $ Responsibility: 0

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

ermCorp
]]>Fri, 26 Apr 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Virginia-Beach-AVP-Senior-Counsel-Job-VA-23450/2453562/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Virginia-Beach-AVP-Senior-Counsel-Job-VA-23450/2453562/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22485 # Positions 1
Location US-LA-Metairie
Search Category Medical Director
Type Regular Full-Time (30+ hours) Posted Date 4/4/2013
Additional Locations ..

More information about this job:
Summary:

Provides support in overseeing medical care for Amerigroup products and services and works collaboratively with other functions that interface with medical management such as provider relations, member services, benefits and claims management. Collaborates with other business leaders, corporate and health plan medical directors to carry out national medical policies.

Responsibilities:

1. Assists in managing medical costs and assuring appropriate health care delivery for Amerigroup health plans, products and services.

2. Provides guidance, support and leadership for utilization management activities.

3. Supports Medical Director(s) in all aspects of utilization, quality and network management.

4. Provides support to nurses and clinical leaders in pre-authorization, concurrent and retrospective review decisions, case management and disease management decisions.

5. Assists Medical Directors and/or National Medical Directors with medical policy; participates in policy review, reviews trends and makes recommendations; may plan, organize and/or direct medical services programs, consisting of all primary and specialty services for in-patient, out-patient, preventive and wellness programs.

6. Assists in the design and implementation of corrective action plans to address issues and improve plan and network managed care performance.

7. Supports URAC, AHCA and NCQA qualification activities. Prepare for site visits and responds to accrediting and regulatory agency feedback.

8. Participates in risk management, claims adjudication, utilization management, catastrophic case review, education and outreach programs, HEDIS reporting, credentialing, peer to peer review, appeals review, denials, etc.

9. Participates in the development of strategic planning for existing and expanding business. Recommends changes in program content in concurrence with changing markets and technologies.

10. Other duties as assigned or requested

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- MD or DO, with board certification in area of specialty.

Preferred:
- Masters in Public Health, MBA or MA.

Years and Type of Experience Required:

Required:
- Minimum of five years clinical experience with at least two years in medical management/health administration in a managed care environment.

Certifications or Licensures

Required:
- Active license to practice medicine without restriction issued by the State Board of Licensure or the State Board of Osteopathic Examiners. Certified in a recognized medical specialty as recognized by the American Board of Medical Specialists (ABMS).

Preferred:
- Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management

Language Skills

Required:
- English

Functional Competencies
- Think creatively, Innovative
- Understanding of financial and business acumen
- Collaborative team player; active listening skills
- Excellent verbal and written communication skills and ability to build and sustain strong working relationships
- Organizational skills and demonstrated ability to multitask and execute
- Strong people leadership and influencing skills
- Strong project management skills; ability to drive programs and lead change
- Knowledge of medical, quality improvement and utilization management practices in a managed care environment
- Knowledge of regulatory and accreditation agencies and requirements
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.
- Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.
- Ability to read, comprehend and interpret complex information and trends to provide accurate and appropriate information to business partners and/or customers.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.

SCOPE INFORMATION

# Direct Reports: As assigned

# Indirect Reports: As assigned

Budgetary $ Responsibility: As assigned

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

CB1

ermEL
]]>Fri, 03 May 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Metairie-Medical-Director-New-Orleans-Job-LA-70001/2530353/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Metairie-Medical-Director-New-Orleans-Job-LA-70001/2530353/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22450 # Positions 1
Location US-VA-Virginia Beach
Search Category Customer Service
Type Regular Full-Time (30+ hours) Posted Date 4/1/2013
Additional Locations ..

More information about this job:
Summary:

With operations in Virginia Beach, the contact center delivers a variety of support resources to Amerigroup members.

At Amerigroup, leaders are focused on supporting our associates by connecting their daily activities with our mission, our vision and the customer service experience. Leaders are challenged to use their analytical skills to identify issues and proactively engage in problem solving that may impact our associates and members. Knowledgeable operations leaders focus on building relationships across functions in order to gain the insight required to support process improvement and people change management.

If you are looking for a way to make a difference and make use of your proven leadership capabilities, you are invited to further explore employment opportunities at Amerigroup.

As a leader in the contact center responsible for Customer Service, the incumbent will be responsible for the implementing policies and procedures which will result in outstanding customer experiences and is accountable for the tactical management of departmental staff. The incumbent is ensures the achievement of all performance goals, adherence to regulatory requirements, coordination of call center activities and implementation of operational processes.

Responsibilities:

1. Coordinates operational resources including staff, technology and training to ensure outstanding customer experiences are achieved while maintaining efficiency.

2. Develops policies, programs and processes to ensure successful communication and education of customers relating to telephonic, web and/or fax inquiries.

3. Plans, organizes and manages call center activities.

4. Generates and evaluates statistical reports on performance or areas of concern to identify trends impeding customer service and/or efficiency.

5. Partners with other operational leaders to resolve recurring issues and provide long term solutions.

6. Develops a high performance team through individual and team development in order to achieve established performance goals for the department.

7. Ensures operations comply with company policies, as well as federal and state regulations.

8. Coordinates the resolution and communication of all customer service issues presented by health plans or management.

9. Manages salary and expense budgets.

10. Establishes or maintains appropriate internal controls and effective performance reporting systems.

11. Ensures the integration of technology and personnel meets the evolving needs of our customers.

12. Performs other duties as assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in related field or equivalent experience.

Preferred:
- Master’s degree in Business or Healthcare Administration.

Years and Type of Experience Required:

Required:
- Seven years of customer service experience within a call center.
- Three years of leadership/management experience.

Preferred:
- Significant experience within managed care operations.

Certifications or Licensures

Preferred:
- Green belt certification.

Language Skills

Required:
- English

Preferred:
- Other languages as determined by business need.

Technical Competencies

Computer Hardware, Software, and Applications/ Office Equipment - Advanced
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.
- Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.

Communication Skills: Verbal, Written and Call Handling - Advanced
- Ability to convey complex messages to a variety of audiences in an effective manner using proper language, grammar and style in the preparation of verbal and written messages to business partners and customers.
- Ability to prepare, edit and clearly convey a variety of messages including presentations, training materials and updates. Ability to handle escalated issues to diffuse concerns through verbal and written messages.

Heath Care Industry Terminology
- Ability to understand basic health care industry terms. Ability to understand how an insurance claim works and use the explanation of benefits to explain details to providers and related business partners.

Read, Interpret and Apply information - Advanced
- Ability to read, comprehend and interpret complex information to provide accurate and appropriate information to business partner or customer.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.
- Ability to understand when to escalate erroneous/inconsistent information discovered in resources to appropriate level of management for review.

Behavioral Competencies

Strategic Leadership

Be Strategic
- Integrates and balances big-picture concerns with day-to-day activities.
- Conveys a thorough understanding of own area's strengths, weaknesses, opportunities, and threats.
- Evaluates and pursues initiatives, investments, and opportunities based on their fit with broader strategies.
- Stays abreast of key competitor actions and their implications or threats to the business.

Make Sound Decisions
- Focuses on important information without getting bogged down in unnecessary detail.
- Probes and looks past symptoms to determine the underlying causes of problems and issues.
- Brings to bear the appropriate knowledge, information, and expertise in making decisions.

People Leadership

Develop / Support Organizational Talent
- Identifies the qualifications required for successful job performance.
- Provides honest, helpful feedback to others on their performance.
- Helps others identify and prioritize their development objectives.
- Promotes sharing of expertise and a free flow of learning across the organization.

Ensure Collaboration
- Discourages "we vs. they" thinking.
- Appropriately involves others in decisions and plans that affect them.
- Works to remove barriers to collaboration.
- Seeks to understand and address the concerns and interests of others with opposing viewpoints.

Results Leadership

Show Drive and Initiative
- Does not easily give up in the face of unexpected obstacles.
- Sets high standards of performance for self and others.
- Puts in extra effort and work to accomplish critical or difficult tasks.
- Tackles tough challenges or problems quickly and directly.

Accountability/Optimize Execution
- Conveys clear expectations for assignments.
- Delegates assignments to the lowest appropriate level.
- Monitors progress of others and redirects efforts when goals change or are not met.
- Holds people accountable for achieving their goals.

SCOPE INFORMATION

# Direct Reports: 3-8

# Indirect Reports: 125-150

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

ermCS
]]>Thu, 02 May 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Virginia-Beach-Director-Customer-Care-Job-VA-23450/2523308/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Virginia-Beach-Director-Customer-Care-Job-VA-23450/2523308/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22649 # Positions 1
Location US-TN-Nashville
Search Category Customer Service
Type Regular Full-Time (30+ hours) Posted Date 4/24/2013
Additional Locations ..

More information about this job:
Summary:

With operations in Tennessee, the contact center delivers a variety of support resources to Amerigroup members.

At Amerigroup, leaders are focused on supporting our associates by connecting their daily activities with our mission, our vision and the customer service experience. Leaders are challenged to use their analytical skills to identify issues and proactively engage in problem solving that may impact our associates and members. Knowledgeable operations leaders focus on building relationships across functions in order to gain the insight required to support process improvement and people change management.

If you are looking for a way to make a difference and make use of your proven leadership capabilities, you are invited to further explore employment opportunities at Amerigroup.

As a leader in the contact center responsible for Customer Service, the incumbent will be responsible for the implementing policies and procedures which will result in outstanding customer experiences and is accountable for the tactical management of departmental staff. The incumbent is ensures the achievement of all performance goals, adherence to regulatory requirements, coordination of call center activities and implementation of operational processes.

Responsibilities:

1. Coordinates operational resources including staff, technology and training to ensure outstanding customer experiences are achieved while maintaining efficiency.

2. Develops policies, programs and processes to ensure successful communication and education of customers relating to telephonic, web and/or fax inquiries.

3. Plans, organizes and manages call center activities.

4. Generates and evaluates statistical reports on performance or areas of concern to identify trends impeding customer service and/or efficiency.

5. Partners with other operational leaders to resolve recurring issues and provide long term solutions.

6. Develops a high performance team through individual and team development in order to achieve established performance goals for the department.

7. Ensures operations comply with company policies, as well as federal and state regulations.

8. Coordinates the resolution and communication of all customer service issues presented by health plans or management.

9. Manages salary and expense budgets.

10. Establishes or maintains appropriate internal controls and effective performance reporting systems.

11. Ensures the integration of technology and personnel meets the evolving needs of our customers.

12. Performs other duties as assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in related field or equivalent experience.

Preferred:
- Master’s degree in Business or Healthcare Administration.

Years and Type of Experience Required:

Required:
- Seven years of customer service experience within a call center.
- Three years of leadership/management experience.

Preferred:
- Significant experience within managed care operations.

Certifications or Licensures

Preferred:
- Green belt certification.

Language Skills

Required:
- English

Preferred:
- Other languages as determined by business need.

Technical Competencies

Computer Hardware, Software, and Applications/ Office Equipment - Advanced
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.
- Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.

Communication Skills: Verbal, Written and Call Handling - Advanced
- Ability to convey complex messages to a variety of audiences in an effective manner using proper language, grammar and style in the preparation of verbal and written messages to business partners and customers.
- Ability to prepare, edit and clearly convey a variety of messages including presentations, training materials and updates. Ability to handle escalated issues to diffuse concerns through verbal and written messages.

Heath Care Industry Terminology
- Ability to understand basic health care industry terms. Ability to understand how an insurance claim works and use the explanation of benefits to explain details to providers and related business partners.

Read, Interpret and Apply information - Advanced
- Ability to read, comprehend and interpret complex information to provide accurate and appropriate information to business partner or customer.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.
- Ability to understand when to escalate erroneous/inconsistent information discovered in resources to appropriate level of management for review.

Behavioral Competencies

Strategic Leadership

Be Strategic
- Integrates and balances big-picture concerns with day-to-day activities.
- Conveys a thorough understanding of own area's strengths, weaknesses, opportunities, and threats.
- Evaluates and pursues initiatives, investments, and opportunities based on their fit with broader strategies.
- Stays abreast of key competitor actions and their implications or threats to the business.

Make Sound Decisions
- Focuses on important information without getting bogged down in unnecessary detail.
- Probes and looks past symptoms to determine the underlying causes of problems and issues.
- Brings to bear the appropriate knowledge, information, and expertise in making decisions.

People Leadership

Develop / Support Organizational Talent
- Identifies the qualifications required for successful job performance.
- Provides honest, helpful feedback to others on their performance.
- Helps others identify and prioritize their development objectives.
- Promotes sharing of expertise and a free flow of learning across the organization.

Ensure Collaboration
- Discourages "we vs. they" thinking.
- Appropriately involves others in decisions and plans that affect them.
- Works to remove barriers to collaboration.
- Seeks to understand and address the concerns and interests of others with opposing viewpoints.

Results Leadership

Show Drive and Initiative
- Does not easily give up in the face of unexpected obstacles.
- Sets high standards of performance for self and others.
- Puts in extra effort and work to accomplish critical or difficult tasks.
- Tackles tough challenges or problems quickly and directly.

Accountability/Optimize Execution
- Conveys clear expectations for assignments.
- Delegates assignments to the lowest appropriate level.
- Monitors progress of others and redirects efforts when goals change or are not met.
- Holds people accountable for achieving their goals.

SCOPE INFORMATION

# Direct Reports: 3-8

# Indirect Reports: 125-150

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

ermCS
]]>Wed, 24 Apr 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Nashville-Director-Customer-Care-Job-TN-37201/2564577/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Nashville-Director-Customer-Care-Job-TN-37201/2564577/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22665 # Positions 1
Location US-NY-New York
Search Category Nursing
Type Regular Full-Time (30+ hours) Posted Date 5/16/2013
Additional Locations ..

More information about this job:
Summary:

The Manager of Appeals and Grievances leads the regulatory compliance and operations activities of AMERIGROUP’s Medical Necessity Appeals and Complaints (Grievances) process and tracking. The Manager provides expertise and leadership for AMERIGROUP’s regulatory/contractual obligations of the multiple state regulatory bodies. Requires frequent monitoring and problem solving such as work flows, electronic systems to manage these processes and implementation of solutions with the Health Plans and Corporate entities to ensure regulatory and accreditation needs are met. This position manages the associates in the Complaints and Grievances component of the QI department.

Responsibilities:

1. Manage the Medical Necessity Appeals (MNA) and Complaints process and reporting:
- Provide management and leadership with information and tools for strategic planning and decision making for Amerigroup complaints and medical necessity appeals .
- Provide expertise as the AGP corporate subject matter expert with Health Plans and corporate entities and Regulatory for complaint tracking and MNA. · Develop and maintain productive working relationships with key regulators and Health Plan contacts that leads to a mutual accountability to benefit company-wide operations and activity.
- Subject matter expert/advisor on MNA and complaints requirements and programs, including state-specific/federal requlations and NCQA requirements.
- Oversight of all MNA activity including MNA external reviews, including State Fair Hearings, , Accreditation compliance and policies associated with these processes.

2. Assess, communicate and ensure associate understanding of state and federal regulations, legislation and regulatory requirements that impact AGP-wide business activity and operations.

3. Develop and maintain resource tools for internal education, and compliance assessments.

4. Work with AGP Compliance Dept. to lead AGP and vendor preparations for performance assessments, and internal delegation and compliance audits:
- Prepare AGP and vendor operational leads for targeted audit activity.
- Coordinate and organize desk review submissions and on-site audit materials.
- Lead on-site assessment and audit activity, if needed.
- Facilitate development of corrective action plans (“CAPs”) and oversee CAP implementation.
- Interact with individual Health Plan audit and enforcement agencies to correct deficiencies and minimize administrative actions and sanction activity.

5. Submissions of reports for MNA and complaints/grievances to the appropriate committees and internal departments.

6. Provide feedback on regulatory filings and member correspondence pertaining to MNA and complaint management.

7. Advises AGP markets and corporate groups on the definition of MNA and complaints eliminating grey areas of confusion with provider disputes and MNA. Uses clinical expertise in problem solving for complaint and MNA follow-up needs.

8. Oversee market expansions and new market activities from an operational perspective, developing processes and policies to support the RFP, regulations, or EQRO requirements.

9. Provide management of associates with motivational environment by establishing clear expectations, communicating specific performance feedback and providing timely and thorough performance appraisals:
- Interview, hire and train support staff.
- Counsel support staff and take appropriate disciplinary action.
- Develop and administer team objectives, priorities and strategic action plans for achieving goals.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree. Experience in lieu of degree is acceptable
- Experience with medical necessity appeals process and regulation.

Preferred:

Bachelor’s degree in nursing. Registered Nurse with managed care experience with appeals and grievances process.

Years and Type of Experience Required:

Required:
- 5 years of relevant work experience in the healthcare industry, preferably a managed care environment.
- 3 years of leadership and management experience.

Preferred:
- 1-2 years experience managing appeals and/or complaint processes for large company.
- Extensive knowledge of accreditation requirements for MNA and complaints, including NCQA and AAAHC.
- Extensive knowledge of federal and state managed care regulations.

Specific Technical Skills

Required:
- Intermediate level Microsoft Office Suite skills. Specifically Word and Excel.
- Report development skills including detail needed for specific market and summary for executive reporting.

Preferred:
- Report presentation skills for small and large groups.

Certifications or Licensure

Preferred:
- Registered Nurse (RN).

Other:

Required:
- Strong analytical and organizational skills.
- Excellent verbal and written communication skills.
- Ability to analyze, interpret, and summarize contracts, regulations, policies/procedures, reports and legal documents.
- Ability to respond to questions/concerns from internal customers, External Quality Review Organizations (EQRO) and regulatory agencies.
- Present company position in understandable and unambiguous manner in formal and informal presentations.
- Problem-solver – identify root cause, recommend options and implement/negotiate appropriate solutions.
- Strong team building skills.
- Ability to effectively set priorities and meet commitments.
- Ability to work under pressure and within strict time frames.
- Comfortable interfacing at all levels of the organization.
- Appreciation of cultural diversity and sensitivity towards target population.

SCOPE INFORMATION

# Direct Reports: 2-5

# Indirect Reports: 1-10

Budgetary $ Responsibility:

PHYSICAL REQUIREMENTS
- Must be able to operate a computer and a telephone.
- Manual dexterity to access filing systems.
- Must be able to conduct, facilitate, and actively participate in meetings.
- Periodic travel required - must be able to travel on common carrier.

ermHO
]]>Thu, 16 May 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/New-York-Mgr-Appeals-&Grievance-Quality-Management-Job-NY/2602085/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/New-York-Mgr-Appeals-&Grievance-Quality-Management-Job-NY/2602085/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22770 # Positions 1
Location US-CA-Newbury Park
Search Category Health Care Administration
Type Regular Full-Time (30+ hours) Posted Date 5/6/2013
Additional Locations ..

More information about this job:
Summary:

Responsible for the development, implementation and oversight of integrated Medical Management primarily in the Health Plan. These initiatives will include the establishment of indicators for monitoring and evaluating quality care, appropriateness, continuous improvement, member satisfaction, utilization, and case management across the continuum of care to members. Provides education in the area of healthcare management. Serves as liaison to state regulatory agencies. Participates in accreditation of plan with the National Committee of Quality assurance. Develops professional relationships with community agencies.

Responsibilities:

1. Directs and provides leadership for designing, developing, and implementing the local Plan integrated medical management program to meet the demographic and epidemiological needs of the population serviced.

2. Directs Healthcare Management Program for membership including disease management, case management, and utilization management.

3. Establishes objectives and annual goals in conjunction with the Medical Director to meet objectives established by the Plan CEO/COO and corporate HCMS.

4. Promotes understanding, communication, and coordination of Integrated Medical Management Programs across the health plan.

5. Works with Provider Relations, Quality Management and Health Promotions to develop and implement effective provider communications, quality assurance and member outreach programs.

6. Provides expert consultation to local plan staff on benefits interpretation and utilization and quality management matters.

7. Coordinates on a quarterly basis reporting of quality initiatives to all appropriate plan committees.

8. Ensures support for compliance with National Committee for Quality Assurance (NCQA) and assures compliance with state/and or federal program requirements.

9. Monitors and makes recommendations for oversight of appropriate delegated services.

10. Develops the annual operating and capital budget: ensures that departments stay within budget and accounts for variances.

11. Works collaboratively with key health care professionals toward identification of opportunities for improvement, trend analysis, education and development of appropriate action plans for problems resolution.

12. Other duties as requested or assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelors Degree in a health care field or equivalent experience (equivalent experience equates to 6 years related experience in addition to the required 12 years experience).

Preferred:
- Masters Degree in a health care field, or
- MBA with Health Care concentration.

Years and Type of Experience Required:

Required:
- Minimum of 12 years relevant clinical work experience and at least 7 years of leadership/management experience preferably in a managed care setting , with at least 5 years of clinical experience (post Masters for Behavioral Health).
- Previous experience with NCQA accreditation and HEDIS reporting.

Certifications or Licensures

Required:
- RN, LCSW, LPC

Language Skills

Required:
- English

Functional Competencies
- Proficient in the use of Microsoft Office products, to include Outlook, Word, Excel and PowerPoint.
- Excellent problem solving skills; ability to multi-task and solve complex problems.
- Excellent organizational and analytical skills.

SCOPE INFORMATION

# Direct Reports: 5-30

# Indirect Reports: varies

Budgetary $ Responsibility: As assigned

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

AGP Job Title: VP HCMS

AGP Grade level: 23

AGP Compensation range: $107,021k - $142,695- $178,369k

AGP MJO: 20%

AGP LTI: $15K

ermHO
]]>Mon, 06 May 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Newbury-Park-VP-Healthcare-Mgmt-Svcs-Job-CA-91319/2582906/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Newbury-Park-VP-Healthcare-Mgmt-Svcs-Job-CA-91319/2582906/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22301 # Positions 1
Location US-NATIONWIDE
Search Category Health Care Operations
Type Regular Full-Time (30+ hours) Posted Date 3/17/2013
Additional Locations ..

More information about this job:
Summary:

Ensures all aspects necessary to develop, maintain, and improve provider networks are met consistently to support the achievement of company goals. Functions include, but are not limited to, the identification, targeting, recruiting, contracting, and re-contracting with all types of providers including primary care physicians, specialist, hospitals, and allied services providers. Oversees strategic aspects concerning provider networks providing advice and guidance to the Health Plans. Responsible for maintaining compliance to company standards for areas influencing the management of provider networks. Provides leadership and development to team members within Network Development area.

Responsibilities:

1. Develops and recommends market specific provider network strategy to leverage opportunities and ensure achievement of organizational objectives.

2. Supervises the network development physician recruitment process and collaborates with multiple resources to convey opportunity and project a well-coordinated team.

3. Works collaboratively with the Plan and other cross functional areas to evaluate, recruit and contract with hospitals and organized provider groups.

4. Works collaboratively with finance in setting reimbursement guidelines including market specific models.

5. Creates continuity among all health plans in the areas of provider reimbursement, contracting, standards, and physician performance.

6. Negotiate provider contract language and reimbursement as needed.

7. Establishes standards, programs and process for provider network management, balancing best practices with knowledge of local market factors and needs to ensure success in all markets.

8. Works collaboratively with Business Development on new market development and entry.

9. Manages relationships with ancillary providers and ancillary vendors, and communicates contractual issues with appropriate enterprise departments.

10. Hires and develops staff, and ensures a positive working environment.

11. Performs other duties as requested or assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in business administration, healthcare administration or related field or equivalent experience in lieu of degree.

Preferred:
- Master’s degree in relevant area.

Experience

Required:
- Minimum 12 years relevant health care experience with 7 years management/leadership experience.

Preferred:
- Knowledge of Medicaid and Medicare reimbursement methodologies.

Language Skills

Required:
- English



Functional Competitencies
- Proficient in the use of Microsoft Office products, to include Outlook, Word, Excel and PowerPoint.
- Excellent program management skills, with the capability to effectively manage program and processes across multiple areas of the organization.

SCOPE INFORMATION

# Direct Reports: 2-5

# Indirect Reports: 10-15

Budgetary $ Responsibility: yes, varies.

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

ermHO
]]>Sat, 11 May 2013 02:59:00 GMThttp://www.amerigroup-jobs.com/job/VP-Network-Development-Job/2485328/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/VP-Network-Development-Job/2485328/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22576 # Positions 1
Location US-FL-Tampa
Search Category Health Care Operations
Type Regular Full-Time (30+ hours) Posted Date 4/15/2013
Additional Locations ..

More information about this job:
Summary:

The Medical Practice Consultant will be responsible for working with Primary Care Providers (PCPs) to facilitate the transition and redesign of the delivery of care into Patient Centered Medical Homes (PCMH). The MPC will be the primary liaison, coach, and facilitator working with PCP practices in the PCMH collaboration. The MPC will work with the medical director, along with associated health plan and corporate personnel to support and promote Amerigroup’s medical home initiative and strategy.

Responsibilities:

1. Performs practice assessments to provide a baseline understanding and a gap analysis from which to develop the action plan for practice transformation.

2. In conjunction with the practice, develops a Practice Transformation Plan (PTP) with goals, timelines, and redesign team ownership.

3. Provides onsite change management and quality improvement coaching to PCPs in their practice transformation.

4. Analyzes, summarizes, and shares provider collaboration reports, identifying gaps and opportunities for improvement. Understands performance reporting and measurement and has the ability to explain data reports. In addition, assures that participating practices submit their measures/metrics and monthly/quarterly reports.

5. Works with health plan leadership to identify and assess provider groups for engagement in the PCMH initiative.

6. Educates participating providers & staff on the PCMH initiative and enhanced reimbursement strategies, external recognition/accreditation programs and HITECH meaningful use criteria and coaches practice to achieve them.

7. Tracks and responds to in-person, telephonic, and written inquiries from providers and document all contacts in appropriate system per Plan (i.e. Sales force).

8. Takes an active role in ongoing program development and evaluation.

9. Performs other duties as assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in Business Administration & Management, Healthcare Administration and Management or related field.

Preferred:
- Coursework focusing on organizational behavior, leadership, change management, quality improvement, or health care.

Years and Type of Experience Required:

Required:
- Minimum 5 years of combined experience in health care, project management, quality management, professional training/teaching, or provider practice management.

Preferred:

Experience with one or more of the following:
- Process Improvement experience or Lean Six Sigma.
- Project management Practice Management.
- Quality Management/HEDIS measurements.
- Clinical Experience (RN, PA, or NP).
- Health care medical economics principles and concepts.

Specific Technical Skills

Required:

RELATIONSHIP BUILDING
- Ability to cultivate and maintain positive internal and external relationships.
- Excellent interpersonal skills.
- Excellent social skills.
- Thorough appreciation of cultural diversity and sensitivity toward target populations.

PROJECT MANAGEMENT
- Ability to work independently.
- Organization, planning, setting goals and objectives, time management.
- Ability to move toward multiple long-term goals, including coordinated internal and external improvement efforts, while meeting short-term objectives.

QUALITY IMPROVEMENT
- Ability to analyze, interpret, and support recommendations with statistical data o Demonstrated understanding of relevant quality improvement tools.

COACHING/TEACHING
- Ability to effectively communicate statistical and qualitative interpretations in a non-offensive manner to medical professionals and staff.
- Ability to guide the provider to better performance.
- Ability to demonstrate relevant quality improvement and project management tools to PCP staff, and to get sustainable commitment from staff to use them effectively.
- Understanding of adult learning and organizational behavior, particularly leadership and organizational change.
- Experienced in developing (professional-level) presentations.
- Excellent verbal and (professional-level) written communications skills.
- Ability to learn from PCP staff, as well as teach them.
- Ability to lead internal and external process improvement efforts.

Certifications or Licensures

Preferred:
- Certification that documents understanding of relevant project management and quality improvement tools.

Examples include:
- Lean Six Sigma (Green Belt or above).
- Clinical License (LPN, RN, NP, PA, or LCSW).

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

ermHO
]]>Tue, 14 May 2013 02:59:00 GMThttp://www.amerigroup-jobs.com/job/Tampa-Medical-Practice-Consultant-Job-FL-33601/2546974/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Tampa-Medical-Practice-Consultant-Job-FL-33601/2546974/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22674 # Positions 1
Location US-TX-Houston
Search Category Customer Service
Type Regular Full-Time (30+ hours) Posted Date 4/24/2013
Additional Locations ..

More information about this job:
Summary:

Provides leadership and day-to-day direction for production-related claims activities across all markets within the claims department, to include: claims processing and payment, management reporting and management and development of staff. Develops and implements policies, procedures and processes that ensure the timely payment of claims in accordance with contractual, State and Federal requirements.

Responsibilities:

1. Evaluates and manages all daily activities and issues involving the accurate and timely processing of claims within state and federal requirements and performance guarantees for assigned markets/products. Sets goals to meet and exceed customer expectations.

2. Manages the day-to-day activities of assigned associates, supervises staff creating development plans for associates, providing timely and effective feedback, and develops corrective action plans when needed.

3. Develops strong relationships with internal/external partners, practicing excellent customer relations and attention to customer needs.

4. Ensures the preparation and analysis of all standard claim reports as requested (i.e. aging, contact logs, quality reports and action grams, etc).

5. Monitors claims processing activities to ensure that the organization’s service, quality, productivity and financial standards or goals are achieved.

6. Develops policies, procedures and processes to ensure the successful implementation of new or revised contracts in accordance with Federal, State and other regulatory agency requirements.

7. Serves as the department expert for the Health Plan in the areas of provider billing, provider reimbursement and benefits. Interprets contract language and rates and coordinates with other internal customers to ensure the accuracy of system configuration and claims processing.

8. Reviews and responds to all regulatory updates and ensures all statistical performance reports are generated within the required time frames.

9. Initiates and leads communication with claims teams and other functional areas to ensure resolution to issues and provide long-term solutions.

10. Assists with meeting budget and understanding capacity model/management for assigned markets to effectively and appropriately staff for claim volume.

11. Adheres to and manages to ensure the adherence to all Amerigroup and department policies and procedures, as well as HIPAA regulations.

12. Develops and implements process improvements with high impact to increase/improve productivity and quality results within the department.

13. Performs other duties as assigned or requested.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in related field or equivalent experience.

Years and Type of Experience Required:

Required:
- Five years of experience in health care claims administration or in a health care insurance company management capacity with at least one year of leadership/supervisory experience.

Internal candidates:
- Demonstrated proficiency and two years experience as a Supervisor/Manager within the company.
- Successful completion of Amerigroup Leadership Development Program in lieu of above years of experience.

Preferred:
- Claims processing experience.

Language Skills

Required:
- English

Technical Competencies Computer Skills and Office Equipment
- Ability to use software and hardware of a computer to complete certain moderately-complex to complex tasks.
- Able to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse, keyboard and 10 key.
- Use of internet, familiarity with SharePoint sites.
- Ability to review and draft correspondence in email system and word processing systems.
- Ability to use software for data analysis, reporting and sharing of information to problem solve.
- Ability to create and manipulate spreadsheets (i.e., data entry and format cells). - Ability to work in databases.

Office Math Skills
- Ability to process numbers, which is an essential skill for any problem solving situation in a claims environment.
- Skills in the use of a calculator (using percentages, multiplication and division) to determine appropriate benefit payment.
- Ability to calculate the manual pricing of claims. Skills to verify accuracy with visual percentage calculations. Read, Interpret and Apply information
- Ability to research information using available resources.
- Read and comprehend the information to analyze and apply logical thinking in making sound decisions.
- Understand and apply general instructions to appropriately and accurately process claims.
- Capacity to follow step-by-step and general directions, remain detail oriented and verify data including HIPAA documentation.
- Ability to investigate and review claim from initial receipt.
- Ability to apply in-depth problem solving with more complex claims.
- Ability to read and interpret contracts for outpatient and inpatient claims.
- Ability to prepare written communication to providers documenting the results of their inquiry.
- Ability to convey results of inquiry through written communication (letter, fax, e-mail) or verbal communication (telephone).

Medical & Billing Terminology
- Understanding of medical terminology used in claims documentation.
- Working knowledge of Medicaid and Medicare benefits.
- Familiarity with claims medical coding.
- Knowledge of the different standard claims forms used for physician and hospital billing.
- Understand COB and LTC processes.
- Knowledge of state and/or federal guidelines that apply to the Medicaid or Medicare benefits.
- Understand the different levels of care and applicable payment methodology.

Claims System Familiarity
- Understanding of the claims payment system.
- Ability to access documentation through the use of an image repository-review system, such as Macess.
- Ability to apply multiple market information and process high dollar claims due to authorization level.
- High level understanding of system configuration for benefits, pricing, and provider set up.
- Ability to identify system issues to management for problem solving.

Behavioral Competencies

Strategic Leadership

Be Strategic
- Demonstrates understanding of the organization's mission and strategies.
- Sees the "big picture" (e.g., overall themes, trends, goals).
- Integrates and balances big-picture concerns with day-to-day activities.
- Establishes strategies for achieving individual or work unit goals.

Make Sound Decisions
- Analyzes, incorporates and applies new information and concepts.
- Recognizes symptoms that indicate problems.
- Makes sound decisions on everyday issues and problems.
- Makes timely decisions on problems/issues requiring immediate attention.

People Leadership Develop/Support Organizational Talent
- Identifies and recruits/refers qualified people.
- Makes accurate evaluations of people's capabilities and fit.
- Provides honest, helpful feedback to others on their performance.
- Shares own experience and expertise with others.

Ensure Collaboration
- Provides sound rationale for recommendations.
- Solicits support for ideas.
- Ensures that own positions address others' needs and priorities.
- Builds relationships to create a foundation for future influence.

Results Leadership Show Drive and Initiative
- Identifies what needs to be done and does it.
- Maintains a consistent, high level of productivity.
- Takes personal responsibility to make decisions and take action.
- Does not easily give up in the face of unexpected obstacles.

Accountability / Optimize Execution
- Juggles many priorities and competing demands for one's time.
- Conveys clear expectations for assignments.
- Removes obstacles in order to move the work forward and/or get efforts back on track.
- Seeks additional resources to complete tasks when needed.

SCOPE INFORMATION

# Direct Reports: 15-25

# Indirect Reports: 0

Budgetary $ Responsibility: N/A

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to AMERIGROUP travel policies and procedures.

ermCS
]]>Wed, 24 Apr 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Houston-Mgr-Claims-Job-TX-77001/2564571/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Houston-Mgr-Claims-Job-TX-77001/2564571/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22893 # Positions 1
Location US-NATIONWIDE
Search Category Quality
Type Regular Full-Time (30+ hours) Posted Date 5/17/2013
Additional Locations ..

More information about this job:
Summary:

The HCE Analyst III – Fraud, Waste, and Abuse Modeler is responsible for the developing, monitoring, and improving business rules and models to identify suspect providers, inclusive of facilities. The ideal candidate has interest in health care fraud, waste, and abuse trends and strong background in analytics, statistics, and/or building predictive models.

Responsibilities:

1. Responsible for conducting advanced data management.

2. Develops and executes complex programs to produce reporting deliverables.

3. Performs business requirements gathering and analysis.

4. Provides technical and/or analytical support as well as professional development to Plan Performance measurement staff.

5. Collaborates with internal and external partners and organizations to understand data needs and design analytic studies to answer business and research questions.

6. Independently structures advanced level project plans for analytical projects.

7. Interprets results and prepares findings for presentation to internal and external audiences.

8. Conducts quality reviews on own and peers’ work products.

9. Integrates feedback to drive continuous improvement and grow subject matter knowledge.

10. Applies advanced financial, clinical and/or operational analysis.

11. Monitors and identifies unit cost and/or utilization risks to AMERIGROUP’s medical cost budget. Elevates and presents to HCE management as necessary.

12. Adheres to all applicable compliance standards.

13. Other job duties as assigned or requested.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in Finance, Economics, Business Administration or a related discipline or equivalent experience.

Preferred:
- Master’s degree or doctorate in Computer Science, Statistics, Mathematics, Finance, Economics or related disciplines.

Years and Type of Experience Required:

Required:
- Minimum of five years of related work experience in data analysis, report development, application development/implementation and /or project management.

Preferred:
- Minimum of two years experience with Managed Care Organization.
- Minimum of two years experience with government health care programs.
- Minimum one year of experience with fraud, waste, and abuse domain in Managed Care Organizations and government health care programs.
- Minimum one year of experience with data manipulation and predictive model building/deployment.
- Minimum one year of experience with programming/scripting languages

Language Skills

Required:
- English

Communication skills

Verbal, Written and Telephonic
- Strong capability to provide professional and appropriate written and verbal information to internal and external customers.
- Strong customer service/relationship skills and ability to work effectively and multi-task in a fast paced environment with shifting priorities.

Computer Skills and Office Equipment
- Proficiency with Microsoft Office products, Excel in particular.
- Programming language such as SQL or SAS preferred Communication skills: Verbal, Written and Telephonic.
- Strong capability to provide professional and appropriate written and verbal information to internal and external customers.
- Strong customer service/relationship skills and ability to work effectively and multi-task in a fast paced environment with shifting priorities.

Behavioral Competencies

Strategic Leadership

Be Strategic
- Demonstrates understanding of the organization's mission and strategies.
- Works to clarify and understand the broader purpose and mission of own work.
- Integrates and balances big-picture concerns with day-to-day activities.
- Generates innovative ideas and solutions to problems.
- Identifies opportunities to increase efficiency, simplicity, and revenue.

Make Sound Decisions
- Approaches problems with curiosity and open-mindedness.
- Collects sufficient information to understand problems and issues.
- Analyzes problems and issues from different points of view.
- Applies accurate logic and common sense in making decisions.

People Leadership Develop/Support Organizational Talent
- Relates to people in an open, friendly, and accepting manner.
- Treats others with respect.
- Listens carefully and attentively to others’ opinions and ideas.
- Maintains positive relationships even under difficult or heated circumstances.
- Works cooperatively with people from different cultural backgrounds.

Ensure Collaboration
- Encourages people to draw on each other's strengths and experience to work together effectively, within and across teams.
- Appropriately involves others in decisions and plans that affect them.
- Provides honest, helpful feedback to others on their performance.
- Shares own experience and expertise with others.

Results Leadership Show Drive and Initiative
- Demonstrates a "can-do" spirit, a sense of optimism, ownership, and commitment.
- Maintains a consistent, high level of productivity.
- Takes personal responsibility to make decisions and take action.
- Does not easily give up in the face of unexpected obstacles.
- Projects a positive image and serves as a role model for others.

Accountability / Optimize Execution
- Juggles many priorities and competing demands for one's time.
- Acts resourcefully to ensure that work is completed within specified time and quality parameters.
- Removes obstacles in order to move the work forward and/or get efforts back on track. Surfaces problems and issues before projects get derailed.

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedure.

D: JR

ermHO
]]>Fri, 17 May 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Health-Care-Economics-Analyst-III-StatisticianLogistics-Modeling-%28position-located-Job/2604271/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Health-Care-Economics-Analyst-III-StatisticianLogistics-Modeling-%28position-located-Job/2604271/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2012-20398 # Positions 1
Location US-TX-Grand Prairie
Search Category Medical Director
Type Regular Full-Time (30+ hours) Posted Date 9/11/2012
Additional Locations ..

More information about this job:
Summary:

Responsible and accountable for assuring appropriate health care delivery for Amerigroup health plans, products and services. Leads, develops, directs and implements clinical and non-clinical activities that impact health care quality, cost and outcomes. Interprets existing medical policies and participates in the development and execution of new policies based on changes in the healthcare or medical arena Supports medical management and other health plan staff in timely and consistent responses to members and providers.

Responsibilities:

1. Designs and implements corporate and/or health plan medical policies, goals and objectives, reviews trends and makes recommendations; plans, organizes and directs medical services programs, consisting of all primary and specialty services for in-patient, out-patient, preventive and wellness programs.

2. Assists with the development of budgets, staffing plans and medical loss ratio projections, assuring the adequate allocation of resources to the medical management functions.

3. Provides professional leadership and direction to the functions within Medical Management, to include Utilization and Case Management, Cost Management and Clinical Quality Management.

4. Drives provider collaboration initiatives and performance monitoring; designs and implements corrective action plans to address issues and improve plan and network managed care performance.

5. Collaborates with provider and government/external relations to improve brand reputation and credibility with constituents.

6. Participates in the retrospective review and analysis of health plan performance from analyzing trends and summary data of paid claims, encounters, authorization logs, complaint and grievance logs and other sources.

7. Supports URAC, AHCA and NCQA qualification activities. Prepares for site visits and responds to accrediting and regulatory agency feedback.

8. Participates in risk management, claims adjudication, utilization management, catastrophic case review, education and outreach programs, HEDIS reporting, credentialing, peer to peer review, appeals review, denials, etc.

9. Participates in the development of strategic planning for existing and expanding business. Recommends changes in program content in concurrence with changing markets and technologies.

10. Monitors member and provider satisfaction survey results and implements changes as needed to increase satisfaction and assure that satisfactory relationships are maintained between network and plan participants.

11. Assists with the contracting process for providers, hospitals, ancillary providers and emergency and other supports services and evaluates the medical aspects of provider contracts.

12. Other duties as assigned or requested

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- MD or DO, with board certification in area of specialty

Preferred:
- Masters in Public Health, MBA or MA Years and Type of Experience Required: Required:
- Minimum of ten years clinical experience with at least three years in medical management/health administration in a managed care environment.
- Minimum of 7 years of leadership/management experience.
- Extensive managed care or Medicare knowledge

Certifications or Licensures

Required:
- Active license to practice medicine without restriction issued by the State Board of Licensure or the State Board of Osteopathic Examiners. Certified in a recognized medical specialty as recognized by the American Board of Medical Specialists (ABMS).

Preferred:
- Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management

Language Skills

Required:
- English

Functional Competencies
- Think creatively, Innovative
- Understanding of financial and business acumen
- Collaborative team player; active listening skills
- Excellent verbal and written communication skills and ability to build and sustain strong working relationships
- Organizational skills and demonstrated ability to multitask and execute
- Strong people leadership and influencing skills
- Strong project management skills; ability to drive programs and lead change
- Knowledge of medical, quality improvement and utilization management practices in a managed care environment
- Knowledge of regulatory and accreditation agencies and requirements
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.
- Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.
- Ability to read, comprehend and interpret complex information and trends to provide accurate and appropriate information to business partners and/or customers.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.

SCOPE INFORMATION

# Direct Reports: 0-5

# Indirect Reports: 0-75

Budgetary $ Responsibility: Varies

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

HEC:DW

ermEL
]]>Tue, 30 Apr 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Houston-Sr-Medical-Dir-Job-TX-77001/2144639/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Houston-Sr-Medical-Dir-Job-TX-77001/2144639/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22730 # Positions 1
Location US-TX-Grand Prairie
Search Category Medical Director
Type Regular Full-Time (30+ hours) Posted Date 5/2/2013
Additional Locations ..

More information about this job:
Summary:

Responsible and accountable for assuring appropriate health care delivery for Amerigroup health plans, products and services. Leads, develops, directs and implements clinical and non-clinical activities that impact health care quality, cost and outcomes. Interprets existing medical policies and participates in the development and execution of new policies based on changes in the healthcare or medical arena Supports medical management and other health plan staff in timely and consistent responses to members and providers.

Responsibilities:

1. Designs and implements corporate and/or health plan medical policies, goals and objectives, reviews trends and makes recommendations; plans, organizes and directs medical services programs, consisting of all primary and specialty services for in-patient, out-patient, preventive and wellness programs.

2. Assists with the development of budgets, staffing plans and medical loss ratio projections, assuring the adequate allocation of resources to the medical management functions.

3. Provides professional leadership and direction to the functions within Medical Management, to include Utilization and Case Management, Cost Management and Clinical Quality Management.

4. Drives provider collaboration initiatives and performance monitoring; designs and implements corrective action plans to address issues and improve plan and network managed care performance.

5. Collaborates with provider and government/external relations to improve brand reputation and credibility with constituents.

6. Participates in the retrospective review and analysis of health plan performance from analyzing trends and summary data of paid claims, encounters, authorization logs, complaint and grievance logs and other sources.

7. Supports URAC, AHCA and NCQA qualification activities. Prepares for site visits and responds to accrediting and regulatory agency feedback.

8. Participates in risk management, claims adjudication, utilization management, catastrophic case review, education and outreach programs, HEDIS reporting, credentialing, peer to peer review, appeals review, denials, etc.

9. Participates in the development of strategic planning for existing and expanding business. Recommends changes in program content in concurrence with changing markets and technologies.

10. Monitors member and provider satisfaction survey results and implements changes as needed to increase satisfaction and assure that satisfactory relationships are maintained between network and plan participants.

11. Assists with the contracting process for providers, hospitals, ancillary providers and emergency and other supports services and evaluates the medical aspects of provider contracts.

12. Other duties as assigned or requested

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- MD or DO, with board certification in area of specialty

Preferred:
- Masters in Public Health, MBA or MA Years and Type of Experience Required: Required:
- Minimum of ten years clinical experience with at least three years in medical management/health administration in a managed care environment.
- Minimum of 7 years of leadership/management experience.
- Extensive managed care or Medicare knowledge

Certifications or Licensures

Required:
- Active license to practice medicine without restriction issued by the State Board of Licensure or the State Board of Osteopathic Examiners. Certified in a recognized medical specialty as recognized by the American Board of Medical Specialists (ABMS).

Preferred:
- Certification by the American Board of Quality Assurance and Utilization Review Physicians or the American Board of Medical Management

Language Skills

Required:
- English

Functional Competencies
- Think creatively, Innovative
- Understanding of financial and business acumen
- Collaborative team player; active listening skills
- Excellent verbal and written communication skills and ability to build and sustain strong working relationships
- Organizational skills and demonstrated ability to multitask and execute
- Strong people leadership and influencing skills
- Strong project management skills; ability to drive programs and lead change
- Knowledge of medical, quality improvement and utilization management practices in a managed care environment
- Knowledge of regulatory and accreditation agencies and requirements
- Ability to use software and hardware of a computer to complete certain moderate to complex tasks. Skills to use basic office equipment such as telephone, fax machine and copy machine.
- Working knowledge in a windows environment to include navigation skills using a mouse and keyboard. Use of internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.
- Ability to use software to conduct data analysis, reporting and sharing of information to solve problems. Ability to use of complex applications of software to analyze and solve business problems.
- Ability to read, comprehend and interpret complex information and trends to provide accurate and appropriate information to business partners and/or customers.
- Ability to research information using available resources and determine where gaps in information exist to seek other sources.

SCOPE INFORMATION

# Direct Reports: 0-5

# Indirect Reports: 0-75

Budgetary $ Responsibility: Varies

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

CB1

ermEL
]]>Thu, 02 May 2013 00:00:00 GMThttp://www.amerigroup-jobs.com/job/Grand-Prairie-Sr-Medical-Dir-DFW-TEXAS-Job-TX-75050/2578754/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Grand-Prairie-Sr-Medical-Dir-DFW-TEXAS-Job-TX-75050/2578754/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2013-22397 # Positions 1
Location US-TN-Nashville
Search Category Case Management
Type Intern Posted Date 3/26/2013
Additional Locations ..

More information about this job:
Summary:

The Summer Internship Program is a ten-week program consisting of various assignments through corporate departments combined with leadership development. Internships will be assigned to one department for the entire program, but will attend training and development meetings in an environment with other interns. Interns may work with the following departments: Call Center Operations, Healthcare Management Services, Provider Services, Finance, Information Technology, Marketing and Business Development, Communications, Human Resources and Health Plan Operations. Internships will focus on building general business knowledge, while receiving mentoring and leadership opportunities.

Responsibilities:

Based on assignment, PRIMARY RESPONSIBILITIES may include one or more of the following:

1. Research and Analysis

a. Assists with research, analytics, and support efforts related to new markets, new products, mergers and acquisitions.

2. Process Improvement and Documentation

a. Assists with project analysis (operational, analytical, and financial) aimed at maximizing revenue and efficiencies while reducing medical, administrative, and other costs.

b. Contributes to the development and documentation of policies, procedures, and processes.

3. Project Management

a. Assists with the development and monitoring of project schedules, budgets, and resources.

b. Communicates key areas of concern or risk toward progress and goals.

4. System Development, Testing and Implementation a. Assists in the development, testing and implementation of systems to improve performance, service, and/or management of key areas.

5. Reporting

a. Assists with monthly reporting to include budget variances, compliance review, and performance metrics analysis.

b. Maintains reports and tracking systems using database applications, such as MS Access and Excel.

6. Program Management a. Supports Healthcare Management Services programs for the prevention/maintenance of physical, developmental, emotional, and addictive diseases.

7. Supervision and Workforce Management

a. Supports the business operations of the National Contact Center and management of call center staff.

b. Reviews metrics, productivity, and service levels needed for workforce management, quality assurance, and improvement initiatives.

8. Overall Business/Market/Healthcare Knowledge

a. Acquires an understanding of the business processes in operational areas.

b. Acquires an understanding of the relationships and interdependencies between departments.

9. Performs other duties as assigned.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Successfully completed 2 years of college with a GPA Average of 3.0 or better.
- Currently enrolled in an accredited college or university actively pursuing a Bachelor's degree.

Years and Type of Experience Required:

Required:
- None

Preferred:
- General Business Knowledge.
- Project management experience and/or project life cycle knowledge.

Specific Technical Skills

Required:
- Strong PC skills to include the MS Office Suite.

Preferred:
- Visio and Project Management Software.
- Knowledge of process improvement and project management including tools and techniques, critical path method, program evaluation and review technique, resource balancing, and cost estimating.

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedures.

ermHO
]]>Wed, 24 Apr 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Nashville-Summer-Internship-Nursing-Student-Job-TN-37201/2506710/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Nashville-Summer-Internship-Nursing-Student-Job-TN-37201/2506710/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Job ID 2012-21239 # Positions 1
Location US-NATIONWIDE
Search Category Health Care Operations
Type Regular Full-Time (30+ hours) Posted Date 11/14/2012
Additional Locations ..

More information about this job:
Summary:

The HCE Analyst III is responsible for collecting, analyzing and interpreting health care data, including claims, clinical, member, and provider information applying problem solving skills to deal creatively with complex less clearly defined situations. Works directly with Plan and Corporate Office customers and business owners to provide solutions to problems of diverse scope with the goal of identifying areas of opportunity for formulation and implementation of strategic initiatives.

Responsibilities:

1. Responsible for conducting advanced data management.

2. Develops and executes complex programs to produce reporting deliverables.

3. Performs business requirements gathering and analysis.

4. Provides technical and/or analytical support as well as professional development to Plan Performance measurement staff.

5. Collaborates with internal and external partners and organizations to understand data needs and design analytic studies to answer business and research questions.

6. Independently structures advanced level project plans for analytical projects.

7. Interprets results and prepares findings for presentation to internal and external audiences.

8. Conducts quality reviews on own and peers’ work products.

9. Integrates feedback to drive continuous improvement and grow subject matter knowledge.

10. Applies advanced financial, clinical and/or operational analysis.

11. Monitors and identifies unit cost and/or utilization risks to AMERIGROUP’s medical cost budget. Elevates and presents to HCE management as necessary.

12. Adheres to all applicable compliance standards.

13. Other job duties as assigned or requested.

Qualifications:

EDUCATION AND EXPERIENCE

Education

Required:
- Bachelor’s degree in Finance, Economics, Business Administration or a related discipline or equivalent experience.

Years and Type of Experience Required:

Required:
- Minimum of five years of related work experience in data analysis, report development, application development/implementation and /or project management.

Preferred:
- Minimum of two years experience with Managed Care Organization.
- Minimum of two years experience with government health care programs.

Language Skills

Required:
- English

Technical Competencies

Computer Skills and Office Equipment
- Proficiency with Microsoft Office products, Excel in particular.
- Programming language such as SQL or SAS preferred Communication skills: Verbal, Written and Telephonic.
- Strong capability to provide professional and appropriate written and verbal information to internal and external customers.
- Strong customer service/relationship skills and ability to work effectively and multi-task in a fast paced environment with shifting priorities.

Behavioral Competencies

Strategic Leadership

Be Strategic
- Demonstrates understanding of the organization's mission and strategies.
- Works to clarify and understand the broader purpose and mission of own work.
- Integrates and balances big-picture concerns with day-to-day activities.
- Generates innovative ideas and solutions to problems.
- Identifies opportunities to increase efficiency, simplicity, and revenue.

Make Sound Decisions
- Approaches problems with curiosity and open-mindedness.
- Collects sufficient information to understand problems and issues.
- Analyzes problems and issues from different points of view.
- Applies accurate logic and common sense in making decisions.

People Leadership Develop/Support Organizational Talent
- Relates to people in an open, friendly, and accepting manner.
- Treats others with respect.
- Listens carefully and attentively to others’ opinions and ideas.
- Maintains positive relationships even under difficult or heated circumstances.
- Works cooperatively with people from different cultural backgrounds.

Ensure Collaboration
- Encourages people to draw on each other's strengths and experience to work together effectively, within and across teams.
- Appropriately involves others in decisions and plans that affect them.
- Provides honest, helpful feedback to others on their performance.
- Shares own experience and expertise with others.

Results Leadership Show Drive and Initiative
- Demonstrates a "can-do" spirit, a sense of optimism, ownership, and commitment.
- Maintains a consistent, high level of productivity.
- Takes personal responsibility to make decisions and take action.
- Does not easily give up in the face of unexpected obstacles.
- Projects a positive image and serves as a role model for others.

Accountability / Optimize Execution
- Juggles many priorities and competing demands for one's time.
- Acts resourcefully to ensure that work is completed within specified time and quality parameters.
- Removes obstacles in order to move the work forward and/or get efforts back on track. Surfaces problems and issues before projects get derailed.

PHYSICAL REQUIREMENTS

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
- Ability to communicate both in person and/or by telephone.
- Must be able to travel as needed and adhere to Amerigroup travel policies and procedure.

ermHO
]]>Tue, 23 Apr 2013 03:00:00 GMThttp://www.amerigroup-jobs.com/job/Virginia-Beach-HCE-Analyst-III-Provider-Collaboration-Analytics-Job-VA-23450/2275979/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSShttp://www.amerigroup-jobs.com/job/Virginia-Beach-HCE-Analyst-III-Provider-Collaboration-Analytics-Job-VA-23450/2275979/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS