Job Family: Digital and Technology
Type: Full time
Date Posted: Nov 30, 2023
Reference: JR96176
Description
About:
Anthem Blue Cross and Blue Shield is a proud member of the Elevance Health family of companies offering Medicare plans, Medicaid, individual and family plans, and group insurance plans in Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, Virginia and Wisconsin. Our group plans include a variety of group medical, pharmacy, dental, vision, life and disability plans flexible enough to fit any size business.
RVP II Provider Solutions (Ohio)
Location: Successful candidate will need to reside in state of Ohio and commutable to an Elevance office location at least 3 days per week (offices in Cincinnati, Columbus, or Cleveland). Relocation assistance available.
The Regional Vice President (RVP) of Ohio Provider Solutions (Healthcare Networks) will have primary responsibility for establishing the overarching strategic framework governing the market’s provider engagement strategy, its approach to complex system negotiations, long-term network development activity, and an end-to-end positive provider experience for all hospitals, professional groups and independent practices throughout the state. This is an incredible opportunity to join a highly impactful leadership team, and to contribute towards truly meaningful work, as a key leader within Elevance.
Primary duties may include, but are not limited to:
Oversees and continuously optimizes Elevance’s care delivery model across Commercial, Medicare Advantage and Medicaid provider network designs.
Develops cost-of-care strategies, site-of-care campaigns and unit price trend management tactics, in partnership with local finance and health economics leaders, with a core focus on sustaining affordability and robust network access for Ohioans.
Develops new and differentiated provider network offerings, based on extensive competitive research, in partnership with the sales, marketing and product teams, for customers of all segments (including ACO payment design constructs, tiered/high-performance networks, etc.).
Integrates components such as efficiency, total-cost, and quality metrics into a retooled approach to health system reimbursement design, enabling an effective transition from fee-based spend to value-oriented incentives over time.
Enables providers for maximum success and leads cohesive provider account management campaigns, in partnership with various internal teams, designed to optimize performance across value-based care agreements, oversee the effective adoption of digital tools, and to streamline operational processes.
Serves as the Provider Solutions (Healthcare Networks) market head for all external affairs, including regulatory matters, advocacy constituency, relevant vendor adoption (hybrid providers) and with traditional care delivery entities.
Ensures operational excellence, including absolute compliance with regulatory and accreditation standards pursuant to provider network requirements.
Hires, trains, coaches, mentors, counsels, and evaluates the performance of approximately 80 direct report associates, including 6-8 directors.
Requires BS/BA in business administration or related healthcare field and a minimum of 8 years of experience (10+ years preferred) in healthcare operations, managed care finance, network development, and/or legal/regulatory; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
MBA or MPH strongly preferred.
Sincere willingness to inspire others, resulting in a team environment/culture of both creativity and true partnership.
Excellent contracting, analytical and negotiation (listening) skills needed.
Proven ability to establish meaningful partnerships with provider systems.
Value-Based Care and government-funded product knowledge.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.