Anthem, Inc. Provider Reimbursement Director in Norfolk, 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: 100% remote; nationwide locations will be considered
The Provider Reimbursement Director position is responsible for leading key provider reimbursement functions and initiatives across the enterprise and serves as subject matter expert regarding provider reimbursement strategies and practices.
Primary duties may include, but are not limited to:
Leads the development and implementation of enterprise-wide provider reimbursement strategies, processes and systems for a major provider type, such as facilities.
Works to drive the adoption and use of standardized reimbursement and contracting methodologies across the enterprise.
Works with medical directors, contract negotiators, cost of care staff and provider relations staff to identify and implement best practice solutions to manage costs and reimburse for services.
Facilitates the communication of activities, emerging trends, and best practices across all units and facilitates implementation of initiatives, through use of a steering committee containing representatives from the company's plans, regions, and business units.
Researches and quantifies the impact of changes to reimbursement methodologies.
May lead fee schedule development for specific plan(s) and/or the development and implementation of clinical editing rules.
Manages special projects and initiatives.
Represents the department and serves as a key contributor on enterprise initiatives, projects, and task forces.
BS/BA degree in a related field
minimum of 10 years business and professional experience in provider reimbursement and contracting, provider relations, and provider servicing; or any combination of education and experience, which would provide an equivalent background.
Masters degree strongly
Nurse Licensure (RN or LPN)
Presenting at an executive level
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.