Norfolk, Virginia

Description

SHIFT: Day Job

SCHEDULE: Full-time

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 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.

Prov Contract/ C of C Consult

This postion is remote near any Anthem office nationwide

Provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues. Works on large scale initiatives with high dollar cost savings opportunities. Partners with provider contractors to develop contracting strategy and supports all aspects of the contract negotiation process. Can work with multiple provider types, e.g. physician, ancillary, medical groups, or hospitals. Supports a full range of contract arrangements and pricing mechanisms. Works on complex enterprise-wide initiatives and acts as project lead.

Primary duties may include, but are not limited to:

  • Uses analytic tools to track both health risks and compliance, as well as supporting the contract negotiation process.
  • Types of analyses include performing sophisticated retrospective data analytics; building new and modifying existing complex models to create predictive impact decision making tools; performing healthcare cost analysis to identify strategies to control costs; projecting cost increases in medical services by using analytic techniques for PMPM trending via multiple variable analysis; preparing pre-negotiation analysis to support development of defensible pricing strategies; performing modeling to compare various contract scenarios based on member utilization patterns and 'what if' logic; measuring and evaluating the cost impact of various negotiation; researching the financial profitability/stability and competitive environment of providers to determine impact of proposed rates; and projects different cost of savings targets based upon various analytics.
  • Identifies cost of care savings opportunities by analyzing practice patterns in relation to office visits, referral practices, and specialty care procedures. Recommends policy changes and claim's system changes to pursue cost savings.
  • Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable.
  • Recommends standardized practices to optimize cost of care.
  • Educates provider contractors on contracting analytics from a financial impact perspective.
  • May recommend alternative contract language and may go on-site to provider premises during contract negotiations.
  • Participates on project team involved with enterprise wide initiatives.
  • Acts as a source of direction, training and guidance for less experienced staff.

Qualifications

Minimum Qualifications: 

  • Requires BS/BA degree in Mathematics, Statistics, or related field; minimum of 5 years experience in broad-based analytical, managed care payor or provider environment; considerable experience in statistical analysis and healthcare modeling; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications: 

  • Master's degree preferred.
  • Contracting experience.
  • Analytical modeling experience.
  • Verbal and written communication skills preferred. 


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.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.

Norfolk, Virginia

If you are active-duty military, reserve, or a military veteran, we foster a welcoming environment that’s dedicated to honoring your service and helping you achieve your career goals. Veterans of Anthem — one of our Business Resource Groups — partners with our Talent Acquisition teams to maximize career offerings for you and your family members, striving to help you transition to civilian service and grow your career at the same time. 

Join Anthem's Military and Veteran Talent Network: https://anthemcareers.ttcportals.com/pages/military 

WE ARE HIRING

Anthem, Inc. is currently seeking military veterans and military spouses for a variety of open tech based roles.  Our immediate needs are in IT support, cyber security, maintenance of digital and automation systems, and network specialists. These roles include Support Technical Engineer, Lead Engineer, Developer, Systems Analyst, Network Data Specialist, and Provider Network Manager roles.  Whether you are looking to transition into an IT career or if you have experience under your belt in the Technology field, Anthem wants to have an impact on your career and professional growth by speaking with you about their career opportunities.

Employee Benefits:

  • Paid Time Off
  • Dental Insurance Plan
  • Medical Insurance Plan
  • Employee Assistance Program
  • Flexible Spending Account
  • Life Insurance
  • 401(k) plan
  • Adoption Assistance
  • New Parent Transition Week
  • Parental Leave
  • Critical Caregiving Leave
  • Back-to-School Assistance
  • Sick Leave

What Happens After I Apply?

Once you click ‘Apply Now’ on an Applied Materials job posting, you will either be re-directed to fill out an application on Applied Materials' career page or be given a confirmation of submission.  If you get redirected, please complete the application on the career page and make sure you have an updated resume uploaded to your RecruitMilitary profile.  Once Applied Materials reviews your resume and profile, a recruiter will reach out to provide you with more information and to schedule you for an interview.

How to Win An Interview

1.     Review the job description for the specific position you are applying for.

2.     Review the company website. Know their mission and values. What do they do? What are their products?

3.     Prepare a few questions to ask on your interview.

4.     Prepare to discuss your military or civilian background and how it relates to the position. 

5.     Check out the RecruitMilitary Resources tab for resume guidance, interview prep and more!

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