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Anthem, Inc. Provider Collaboration Manager or Senior in Cary, North Carolina

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. company, it’s a powerful combination, and 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.

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.

This position may be filled as Provider Collaboration Manager to Provider Collaboration Manager Senior. The level will be determined by Manager in accordance to the incumbents skill-set in relationship to the position.

Provider Collaboration Manager

Receives a moderate level of guidance and direction in providing operational and administrative support for the contracting, implementation, auditing and resolution of loading issues for payment innovation programs. Primary duties may include, but are not limited to:

  • Provides support for assigned provider contracts. Obtains and analyzes financial performance and quality metrics. Support and facilitates value based JOCs (Joint Operating Committee meetings).

  • Develops and maintains contact database and disseminates communications to providers as necessary.

  • Aggregate and analyze provider data form various sources to recommend and implement solutions to assist with provider collaboration activities.

  • Collaborates with provider contractors and network relations reps to meet provider service needs.

  • Encourages providers to act on patient outreach opportunities.

  • Continues to build knowledge of the organization, processes and customers.

  • Performs a range of mainly straightforward assignments

Provider Collaboration Manager Senior

Responsible for providing operational and administrative support for the contracting, implementation, auditing and resolution of loading issues for payment innovation programs. Primary duties may include, but are not limited to:

  • Provides support for assigned provider contracts.

  • Manage and oversee the value based program intake process.

  • Obtains and analyzes financial performance quality metrics and reports to providers on the impact to performance.

  • Support and facilitates value based JOCs (Joint Operating Committee meetings).

  • Develops and maintains contact database and disseminates communications to providers as necessary.

  • Aggregate and analyze provider data from various sources to recommend and implement solutions to assist with provider collaboration activities.

  • Collaborates with provider contractors and network relations reps to meet provider service needs.

  • Encourages providers to act on patient outreach opportunities.

  • Acts as primary point of contact for large health systems and facilitates complex issue resolution

Provider Collaboration Manager or Senior

  • Obtains and analyzes quality metrics and reports for care opportunities, supports practice implementation of care coordination and care management, develops action plans for providers to improve cost, quality and the patient experience

  • Participates in design, development, and implementation of community learning forums.

  • Collaborates with Advanced Medical Home team including but not limited to: collaboration manager, clinical liaison, provider contractors and network relations reps to meet provider and practice service needs.

  • Actively participates in developing program recommendations and action plans (Internal).

  • Supports the efforts of providers and practice teams on office based care delivery interventions resulting in cost of care savings and improved health outcomes for patients.

  • Provides education for practices to develop expertise with metrics and data review for quality improvement.

  • Tracks progress of program and prepares status reports to management or senior management.

  • Maintains up to date knowledge on Care Delivery System Redesign, Accountable Care and Patient Centered Medical Home Organizations.

This position may work remote, must be located in North Carolina.

Qualifications

Provider Collaboration Manager

  • Requires a BA/BS degree; 3 years’ experience in data base maintenance related to health care; or any combination of education and experience, which would provide an equivalent background.

  • Provider environment experience preferred.

Provider Collaboration Manager Senior

  • Requires a BA/BS degree; 5 years’ experience in data base maintenance related to health care; or any combination of education and experience, which would provide an equivalent background.

  • Provider environment experience required.

Specific Qualifications

  • Proficient in Microsoft Word, PowerPoint and Excel, advanced presentation and facilitation skills required.

  • Experience with Tableau is desired.

  • Facets experience is a plus.

  • Previous Quality or HEDIS experience strongly preferred.

  • Physician environment experience in practice transformation/quality improvement, ambulatory care setting quality and efficiency metrics, and electronic health records preferred.

  • Good consultative coaching skills 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. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS43343

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