RVP II Provider Solutions
/ Your Talent. Our Vision. / At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care .
This position maybe located in any state.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.
Responsible for providing local market strategic leadership for provider optimization, service, network competitive intelligence, engagement and contracting for Medicaid Nationwide, including local cost of care and trend management, provider contracting, implementation and local oversight of all types of payment innovation programs, and provider relations and education.
Primary duties may include, but are not limited to:
Delivers competitive cost of care trends in assigned area
Develops provider networks that provide a competitive advantage.
Aligns Medicaid contracting strategy with medical management strategy. Integrates quality metrics and incentives into contracting process.
Serves as Medicaid Provider Solutions local single point of accountability and is the Medicaid lead for the Integrated Cost Management (ICM) committee.
Ensures compliance with regulatory and accreditation standards.
Collaborates with Product Development to recommend and implement innovative benefit plan designs
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires BS/BA in business administration or related healthcare field; 8 years of experience in healthcare operations, finance, underwriting, actuary, network development and/or sales; or any combination of education and experience, which would provide an equivalent background. MBA preferred.
/ Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /
Job Provider Network Management
Equal Employment Opportunity Statement
Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.
Title: RVP II Provider Solutions
Location: new jersey-Iselin
Requisition ID: 131299