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RVP I Provider Solutions (Missouri)

Location:

  • MO, ST LOUIS

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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 I Provider Solutions (Missouri)

Location:  Successful candidate will reside in Missouri and commutable to St. Louis office location at least 3 days per week. Relocation assistance provided.

Role:

Responsible for providing strategic leadership for market specific network strategy development, provider engagement and contracting for assigned state (Missouri) with a benefit spend between $3 billion and $8 billion.

Negotiate provider contracts and value-based agreements with health systems, hospitals, provider groups, individual providers, ancillary and where applicable, Behavioral Health providers for all lines of business, Commercial, Medicaid, and Medicare.

Primary duties may include, but are not limited to:

  • Local cost of care and trend management

  • Local oversight of all types of value based / payment innovation programs.

  • Provider relations account management and education

  • Primary duties may include but are not limited to:

  • Delivers competitive cost of care trends in assigned state for all lines of business, ensuring effective ideation and execution.

  • Develops provider networks that provide a competitive advantage.

  • Actively participate in bid strategy, planning, development and execution

  • Aligns contracting strategy with medical management strategy.

  • Integrates quality metrics and incentives into contracting process.

  • Serves as the Healthcare Networks local single point of accountability for all product lines. Develop and maintain strategic provider relationships, leverage extensive market knowledge.

  • Facilitates the implementation of local system and product consolidation efforts.

  • Ensures compliance with regulatory and accreditation standards. Actively lead and/or engage to ensure networks meet NCQA, state customer and other compliance requirements.

  • Collaborates with Product Development to recommend and implement innovative benefit plan designs.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

  • Responsibility for administering the HealthLink network (rental network)

Qualifications:

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. MBA strongly preferred.

Preferred Skills, Capabilities and Experiences:

  • MBA 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 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.

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