Anthem, Inc. Regional Vice President (RVP) II Provider Solutions - OH (PS40397) in Columbus, Ohio
SHIFT: Day Job
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 at one of America's leading health care companies and a Fortune Top 50 Company.
RVP I Provider Solutions – Ohio
Responsible for providing strategic leadership for provider contracting and network management for assigned state with a benefit spend over $8 billion, including relationship management, local cost of care and trend management, provider contracting, network build, sculpting and management, 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. Supports Stars work including driving provider collaboration and integrating 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 driving network Cost of Care strategies and initiatives. 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. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Must have 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.
Provider Experience, Health Plan Experience, value base contracting experience.
Commercial and Medicaid background provider contract background preferred
Leadership experience, direct management exp. preferred.
Ability to work in any OH Anthem required, Cleveland, Columbus or Mason office preferred.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes.