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 live in state of Ohio. Relocation assistance available.
Responsible for providing strategic leadership for provider engagement and contracting for assigned state with a benefit spend between $3 billion and $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.
Primary duties may include, but are not limited to:
Oversees and continuously optimizes provider service delivery model
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 the contracting process.
Serves as Provider Solutions local single point of accountability for all product lines and is the Ohio lead for the Integrated Cost Management activities versus (ICM) committee.
Facilitates the implementation of the 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 the 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:
MBA strongly preferred
Excellent contracting, analytical and negotiation (listening skills) needed
Proven strategic provider partnership experience
Value-Based on complex arrangements knowledge
Proven experience developing relationships both internal to the organization and external client facing
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. A Fortune 20 company with a longstanding history in the healthcare industry, 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.
Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and 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 – 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. 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.