Anthem, Inc. Provider Collaboration Dir (Ohio) in Seven Hills, Ohio
SHIFT: Day Job
Must be located in Ohio.
Responsible for executing value-based payment strategies across all lines of business (Commercial, Medicare, and Medicaid) to maximize healthcare value delivered to Anthem members
Primary duties may include, but are not limited to:
Collaborate with provider organizations of various size and structure to develop and support successful value-based arrangements, lead committee meetings. Serves as lead to Provider Collaboration Manager and other team members to achieve goals and objectives. Drives medical and behavioral health integration initiatives. Function as company's SME in payment innovation and collaboration programs. Navigates highly matrixed organization to research issues and escalate concerns for resolution. Identifies payment innovation gaps and engages appropriate resources for solution. Analyzes financial performance quality metrics and reports to providers on the impact to performance. Guides providers to move into more mature payment programs including downside risk, capitation, episode bundled payments, etc. Conducts discussions with employer groups and health system executives.
Must be located in Ohio.
Requires a BA/BS degree; 8 years’ experience in contracting (value based including, shared savings, capitation, downside risk and other APM models, and Accountable Care Organization (ACO) development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background. Ability to work independently with decision-making proficiency required. Medicaid value-based contracting experience a plus.
Experience using financial models and analysis to negotiate rates with providers. Requires knowledge of regulatory requirements for line of business.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
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