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Anthem, Inc. Staff VP Network Management in Apple Valley, California

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At CareMore, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination. It’s the foundation upon which we’re creating greater access to 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.

CareMore is a proven care delivery model for the highest-risk. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery. We build and lead integrated, multi-disciplinary clinical teams to care for the most complex patients. We strive for excellence and have achieved significant and measurable improvement in total cost of care, clinical outcomes, and experience. As an Anthem subsidiary, we benefit from the scale and resources one of America’s largest managed healthcare organizations.

Location:

Any Anthem office

Job Summary:

Responsible for network development and provider reimbursement for a regional Health Services Area.

Primary duties may include, but are not limited to:

  • National scope: oversees regionally-focused teams that support contracting, and maintenance of all facilities including hospitals, surgery centers, etc.

  • Demonstrated experience managing and monitoring network performance using cost, quality and outcomes data.

  • Familiarity with downstream Risk Bearing Organization & Independent Physician Association contracting.

  • Oversees the development, maintenance and reconciliation of physician risk contracts and capitated arrangement.

  • Capability to build & sculpt a network within a network (from Broad or fee for service to a subset of higher-performing providers).

  • Attracts, develops and manages key contracting and servicing staff.

  • Develops innovative ways to maintain a cost effective network with adequate access and positive working relationships with providers.

  • Holds accountability to engage with Clients related to Network Initiatives providing strategic focus.

  • Sits at table for client meetings/development of network strategy, participates in client interactions with Sales team.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports and deliver "train the trainer" type support to local market resources; performance of direct reports; will need to drive change, accountability and more robust and standardized national processes.

Qualifications

  • Requires a BS/BA degree in business administration or related healthcare field.

  • 8-10 years healthcare operations, finance, underwriting, actuary, network development and sales experience.

  • Any combination of education and experience, which would provide an equivalent background.

  • CPA or MBA preferred.

  • Experience working with all lines of business (Medicare, Medicaid and Commercial) preferred.

  • Value based contracts experience preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

REQNUMBER: PS40533

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