Anthem, Inc. VBS Clinical Data Exchange - Payment Innovation Director 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.
Payment Innovation Director – VBS Clinical Data Exchange SME (PS65486)
Location: This is a remote, work@home position.
The Value Based Solutions – Provider Product Strategy team is focused on developing and scaling solutions to support our provider partners in the journey from fee-for-service to value-based care. This is a growing and dynamic environment, with opportunity to work on a variety of initiatives. Our product suite includes technology solutions, data analytics and human-enabled services.
The Payment Innovation Director is responsible for supporting value-based providers in effective and efficient submission of clinical data through supplemental files and EMR integration, which support program measures that are a key element of value-based arrangements. Primary duties of this role will be to:
Work with business and technical partners within provider organizations to assess inbound-to-Anthem clinical / supplemental data and communicate results, gaps, and recommendations to achieve mutual business objectives.
Develop scalable business processes and solutions to enable assessment and analysis of routine provider clinical data issues by field-based teams.
BA/BS in business or related field and a minimum of 7 years of experience in healthcare systems, and 5 years of experience in a strategy role; or any combination of education and experience, which would provide an equivalent background.
MBA degree and Previous experience leading design and execution of Value Based Payment Models strongly preferred.
Knowledge of Medicaid and/or Medicare a plus.
A combination of the following is preferred:
Deep knowledge of quality measures and clinical data acquisition processes from an operational / business perspective.
Experienced in explaining complicated, technical concepts to non-technical audiences.
Adept in presenting to all levels of leadership within provider organizations
Strong data manipulation and analysis skills, including robust Excel and Tableau skills.
Strong technical acumen – able to understand and explain the systems that generate and transport clinical data, as well as the characteristics and limitations of that data.
Proficient use of SQL, Tableau and Excel.
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 Anthem. 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 Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
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. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact email@example.com for assistance.