Anthem Provider Networks Director - West CA (Anthem Office Preferred) - PS11502 in Beverly Hills, California

Provider Networks Director - West CA (Anthem Office Preferred) - PS11502

Location: California, United States

Field: Provider Network Management

Requisition #: PS11502

Post Date: Sep 17, 2018

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

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

Responsible for providing strategic leadership for provider engagement and contracting for a California region. Ensures that the organization's policies for drafting contracts conducting negotiations and administering provider agreements are followed. May also be responsible for contractual compliance with government regulations. 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 state.

  • Develops provider networks that provide a competitive advantage.

  • Aligns contracting strategy with medical management strategy.

  • Integrates quality metrics and incentives into contracting process.

  • Serves as Provider Solutions local single point of accountability for all product lines and is the state lead for the Integrated Cost Management (ICM) committee.

  • Facilitates the implementation of local system and product consolidation efforts. Ensures compliance with regulatory and accreditation standards. Collaborates with

  • Product Development to recommend and implement innovative benefit plan designs.

  • 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.

  • May require local travel in the state of CA.

  • Candidate must reside in West CA (proximity to an Anthem Office preferred).

  • An Equal Opportunity Employer/Disability/Veteran Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.