Now Hiring - Anthem, Inc. - Healthcare Provider Relationship Account Management Director in Nashville, TN

The Provider Relationship Account Management Director is responsible for developing and maintaining positive provider relationships with a portfolio of providers within a defined provider relationship account management cohort. May act as a primary point of contact and own relationship, end to end, post contract for strategic initiatives for select strategic providers with complex operating structures such as value-based payment arrangements and diverse integration/risk contracting strategies and/or other strategic growth partners. When acting as primary point of contact will advocate for their portfolio of strategic providers; fully understands their operating /business model and proactively identifies provider needs and recommends ways to improve existing relationships through best practices and manages relationships and provides leadership to dedicated matrixed teams.

How you will make an impact:

• Conducts regular on-site and/or virtual/digital visits, communicates administrative and programmatic changes, and facilitates proactive education and the resolution of highly complex provider issues.
• Serving as a knowledge and resource expert regarding the most complex providers (such as National, Large, Value-Based and High Performing Providers); research, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners and strategies for resolution and escalation of issues and barriers to success as required.
• May be responsible for coordinating non-negotiated contracts for new and existing providers as needed. Expected to support and coordinate "tradeable" amendments on National Facility /Ancillary groups.
• Functions as a high-level technical resource in analyzing what is driving the issues and how to avoid future occurrences
• Leads Joint Operation Committees (JOC), driving the meetings in the discussion of issues and changes.
• Coordinates communications process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns.
• Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery.
• Organizes and executes external Provider Townhalls/Seminars and attend State Association conferences (e.g.: MGMA, AFP, AAP, HFMA).
• Researches and analyzes issues that may impact future provider contract negotiations or jeopardize network retention.
• May provide mentorship, training, guidance to lower-level Provider Relationship Account Management staff.

Requirements:

• Bachelors' degree and a minimum of 5 years of Provider service experience including 3 years of experience in healthcare or a provider environment; or any combination of education and experience, which would provide an equivalent background.
• Assets and preferred qualifications:
• Ability to travel as needed.

Be part of an Extraordinary Team

Elevance 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 World's 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 [please apply online] 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 [please apply online] for assistance.