Anthem, Inc. Cost of Care Manager in Reston, Virginia
SHIFT: Day Job
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 care companies and a Fortune Top 50 Company.
Location: This position is on the Medicare Healthcare Cost Outcomes Cost of Care team. States supported by this position include East and West Regions. Although it is preferred that you work in one of these markets, we are open to any other Anthem office location, or a work at home arrangement. NY, VA, CA, TX, TN
Cost of Care Manager
Leads and manages multiple cost of care initiatives enterprise wide (e.g. local, within each state, across business segments and at the enterprise level) and drives their execution. Understands, predicts and implements measures to control healthcare costs and to make healthcare more affordable for our customers. Develops, manages, oversees and executes new and innovative initiatives to manage rising costs and enhance the company's market competitiveness.
Primary duties may include, but are not limited to:
Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual benefit design participation, and financial operations.
Oversees the identification of potential cost of care savings opportunities through complex analytics via partnering with the cost of care analytics team, to developing action plans, benefits and risk assessments and overseeing and partnering with the actuarial team to develop and ensure accurate savings quantification.
Champions cost of care initiatives, negotiates for human capital resources, and partners with care management, claims, IT, and business partners.
Manages and presents cost of care projects to senior leadership including State Plan Presidents.
Serves on local and enterprise committees.
Plans, leads, and oversees cost of care planning meetings and tracks and reports on cost of care projects.
Requires a BS/BA degree and minimum of 5 years relevant experience in Health Care; or any combination of education and experience, which would provide an equivalent background.
MBA, MHA, MA preferred.
PMP or Six Sigma Green Belt preferred.
Prior experience with provider network contracting, provider networks, claims, finance, and operations preferred.
Healthcare experience is strongly preferred
Prior experience analyzing, reporting, and developing recommendations on health care data 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.