Title: RVP II, Healthcare Networks
Travel: 25% within TX
The RVP II, Healthcare Networks will be responsible for providing strategic leadership for provider engagement and contracting for assigned states (Texas, Arizona, and Mexico) with a benefit spend over $8 billion, 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. This position will be responsible for both Medicare and Medicaid Network contracting for all 3 states mentioned.
The successful candidate will possess strong leadership skills and will be effective in establishing a collaborative relationship with the Texas Medicaid plan. In addition, we will look for strong leadership experience for the 6-7 direct and 60-70 Indirect reports reporting to this position.
Primary duties may include, but are not limited to:
- Delivers competitive cost-of-care trends in the 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.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
- Requires BS/BA in business administration or related healthcare field and a minimum of 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.
Preferred Skills, Capabilities, and Experiences:
- Medicaid and Medicare contracting/RFP proposal experience highly desirable.
- MBA strongly preferred
- JD or legal background
- Compliance, Regulatory and accreditation experience
- Familiarity with Texas provider market
- Strategic visionary with experience with expansion markets
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 firstname.lastname@example.org for assistance.