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Anthem, Inc. Director, Network Management (Physician Contracting) in Melville, New York

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. As one of the leading healthcare companies in the New York area, our mission is to materially and measurably improve the health of every New Yorker. Join us on our mission and together we will transform the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

This position can be located in one of the following Anthem office locations:

New York, NY; Melville, NY; Middletown, NY

At Empire, our providers are at that center of what we do. We work in partnership with the provider community to make an impact on the total health and well-being of New Yorkers and their daily lives. Your contributions to creating and maintaining that leading network will help us to achieve our goals.

The Director, Network Management role is responsible for network development and provider reimbursement strategy for physician contracting in Westchester, New York City, and Long Island. You will be a Team leader (of approximately 20) and report directly to the New York market VP of Provider Solutions and Network Development.

Primary duties may include, but are not limited to:

  • Oversees contracting and maintenance of all professional provider entities, including boutique professional groups, independent provider associations (IPAs) and freestanding ambulatory surgery centers, amongst other physician types.

  • Sets reimbursement strategy and manages towards annual financial trend targets for Commercial, Medicare and Medicaid lines of business.

  • Oversees the development, maintenance and reconciliation of physician risk contracts and value-based reimbursement arrangements in accordance with Empire’s growth priorities.

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

  • Crafts and executes on long-term business plan strategies, such as process improvement initiatives and service enhancements.

  • Develops innovative ways to maintain a cost effective network with adequate access and positive working relationships across each of Empire’s provider types.

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

Qualifications

Requires a BS/BA degree in business administration or related healthcare field; 8-10 years provider contracting, healthcare operations, finance, and network development experience; or any combination of education and experience, which would provide an equivalent background.

  • MPH or MBA preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine. It is a 2019 Diversity Inc. magazine Top 50 Company for Diversity.

If you are ready to help change the face of healthcare in New York, please contact us and apply at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

REQNUMBER: PS36526-Melville-Melville

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