Vacancy caducado!
Provider Networks Director - Northern CA (Rancho Cordova Preferred) - PS25775Location: California, United StatesNewRequisition #: PS25775Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.Provider Networks DirectorLocation: Northern CA (Rancho Cordova Preferred)The Provider Networks Director is responsible for providing strategic leadership for provider engagement and contracting for a California region. Ensures that the organization's policies for drafting contracts, conducting negotiations, and administering provider agreements are followed. May also be responsible for contractual compliance with government regulations. 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:
Delivers competitive cost of care trends in 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.
Requires BS/BA in business administration or related healthcare field; 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 preferred.
25% in state travel required.
Experience in Operations and/or Provider Relations a plus.
Strong negotiating experience.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.
Vacancy caducado!