Anthem Director of Network Management 135844 in New York City, New York

/Your Talent. Our Vision./At Anthem, Inc.,it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater valuefor our customers, and greater health for our communities. Join us and together we willdrive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.

Director of Network Management*

Responsible for leading network management activities for the business, specifically responsible for the total cost of care for a subset of the NY market. The focus will be on hospital, large physician groups, hospital-based physician and facility- based ancillary (i.e. ASCs) contracting and relationship management, as well as project management for medical trend reduction initiatives.

Essential duties include, but are not limited to:

  • Leading contracting negotiations with high-spend facilities, overseeing and managing all other negotiations in assigned region, forecasting unit cost trends and managing to forecasts, developing and implementing plans to achieve unit cost and medical management goals and targets and effectively managing all assigned contract relationships to ensure contract compliance and professional, accurate and timely service.
  • Management duties to include hiring, training, coaching, counseling and evaluating performance of direct reports.
  • Position will also oversee and manage enterprise provider payment innovation and reward programs that focus on either hospitals or physicians.

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

  • CPA or MBA preferred
  • 10 years managed care and provider reimbursement experience, including experience as the lead negotiator with large, complex providers on high-spend facility contracts preferred.
  • 5 years management experience preferred. Experience with direct reports in different locations preferred.
  • Strong analytical and Excel skills are highly desired in top candidate
  • This role is located in New York City (Manhattan) /Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran.__/

Job Provider Network Management

Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.

Title: Director of Network Management 135844

Location: NY-New York City

Requisition ID: 135844