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, Georgia, 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.

Regional Vice President (RVP) Provider Solutions

Location

St. Louis, Missouri

This role requires associates to be in-office at least 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.  Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Summary

The Regional Vice President (RVP) of Provider Solutions will be responsible for strategic leadership over all provider engagement and contracting activity throughout Missouri, including cost of care and trend management strategy, hospital negotiations, network and product design (implementation), and development/oversight of all payment innovation programs (value-based care), provider relations and primary care growth strategy throughout the state. The position holds leadership and end-to-end responsibility over network development activities on behalf of multiple P&Ls.

Team Scope

7-10 direct reports

~35 total FTE’s

Position Responsibilities:

Primary duties may include, but are not limited to:

• Delivers competitive cost of care trends across all lines of business.

• 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.

• Responsibility for administering the HealthLink network (rental network)

Position Requirements:

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, MPH and/or JD preferred.

• Experience in the Missouri health insurance market strongly preferred.

• Excellent network development, contracting, analytical and negotiation (listening) skills.

• Proven strategic provider partnership experience.

• Value-Based contracting expertise and performance management experience.  

• 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.

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 and Influenza. 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.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.