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Provider Collaboration Director (US)

Company: Elevance Health
Location: Virginia Beach
Posted on: November 26, 2022

Job Description:

Provider Collaboration Director (US)

  • Job Family: Digital and Technology
  • Type: Full time
  • Date Posted:Nov 04, 2022
  • Req #: JR28769Location:
    • VA, Richmond
    • Virginia, VirginiaDescriptionProvider Collaboration DirectorLocation: Virginia resident preferredThe Provider Collaboration Director is responsible for local management of Enhanced Personal Health Care (EPHC), payment innovation and collaborative programs across all lines of business.Primary duties may include, but are not limited to:
      • Negotiates individual value-based contracts, plans, manages, and implements strategy for value-based program expansion in a market across Commercial, Medicaid and Medicare Advantage lines of business.
      • Provides provider support for successful value based arrangements w/ focus on large complex program participants; lead committee meetings.
      • Drives medical and behavioral health integration initiatives.
      • Function as company's SME in payment innovation and collaboration programs and mentor for value-based staff.
      • Identifies payment innovation gaps and engages appropriate resources for solution.
      • Analyzes financial performance, quality metrics, risk adjustment, cost trends, and reports to providers on the impact to performance.
      • Guides providers to move into more mature payment programs.
      • Conducts discussions with employer groups and health system executives.Requirements:
        • a BA/BS degree and a minimum of 8 years experience in contracting (value based, shared savings and Accountable Care Organization (ACO) development), provider relations, provider servicing; experience must include prior value-based reimbursement program and contracting experience; or any combination of education and experience, which would provide an equivalent background.
        • Requires knowledge of regulatory requirements for line of business, understanding of shared savings models including but not limited to trended cost and MLR, and risk adjustmentPreferred:
          • Experience using financial models and analysis to negotiate rates with providers strongly preferred.Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.Be part of an Extraordinary TeamElevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide and Elevance Health approves a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 Worlds Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.EEO is the LawEqual Opportunity Employer / Disability / VeteranPlease use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.
            • EEO Policy Statement
            • EEO is the Law Poster
            • EEO Poster Supplement-English Version
            • Pay Transparency
            • Privacy Notice for California ResidentsElevance Health, Inc. is an E-verify EmployerNeed Assistance?Email us ( or call 1-877-204-7664

Keywords: Elevance Health, Virginia Beach , Provider Collaboration Director (US), Executive , Virginia Beach, Virginia

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