Anthem Cost of Care Director (132480) in Lynnwood, Washington

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.

Leads and manages multiple cost of care initiatives including the most complex 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 competiveness.

Primary duties may include, but are not limited to:

  • Identifies and develops best practices and cost of care improvement processes that engage physicians, hospitals and ancillary providers.

  • Identifies provider centric negociation strategies, steerage and utilization management efforts to reduce cost of care.

  • 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 of IPAs, MSOs and ACOs.

  • Serves on provider led quality and cost of care committees.

  • Plans, leads and oversees cost of care planning meetings and tracks and reports on cost of care projects.

  • May mentor and/or provide training and assistance to external partners.

/ Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran. /

Requires a BS/BA degree; Financial, Business, and Leadership acumen; at least 9 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.

Experience working with external provider and client groups. Provider network contracting, provider networks, claims, finance, and operations preferred.

Job Provider Network Management

Title: Cost of Care Director (132480)

Location: washington-Lynnwood

Requisition ID: 132480