Job Description
About the position Anthem bolthires and bolthires is a proud member of the Elevance Health family of companies offering Medicare plans, Medicaid, individual and family plans, and group insurance plans in Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, Virginia and Wisconsin. Our group plans include a variety of group medical, pharmacy, dental, vision, life and disability plans flexible enough to fit any size business. Regional Vice President (RVP) Provider Solutions Location St.
Louis, Missouri
This role requires associates to be in-office at least 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Summary
The Regional Vice President (RVP) of Provider Solutions will be responsible for strategic leadership over all provider engagement and contracting activity throughout Missouri, including bolthires of care and trend management strategy, hospital negotiations, network and product design (implementation), and development/oversight of all payment innovation programs (value-based care), provider relations and primary care growth strategy throughout the state. The position holds leadership and end-to-end responsibility over network development activities on behalf of multiple P&Ls.
Team Scope 7-10 direct reports ~35 total FTE's Responsibilities • Delivers competitive bolthires of care trends across all lines of business. • Develops provider networks that provide a competitive advantage. • Aligns contracting strategy with medical management strategy. • Integrates quality metrics and incentives into contracting process. • Serves as Provider Solutions local single point of accountability for all product lines and is the state lead for the Integrated bolthires Management (ICM) committee. • Facilitates the implementation of local system and product consolidation efforts.
• Ensures compliance with regulatory and accreditation standards. • Collaborates with Product Development to recommend and implement innovative benefit plan designs. • Hires, trains, coaches, counsels, and evaluates performance of direct reports. • Responsibility for administering the HealthLink network (rental network) Requirements • BS/BA in business administration or related healthcare field and a minimum of 8 years of experience in healthcare operations, finance, underwriting, actuary, network development, and/or sales; or any combination of education and experience, which would provide an equivalent background.
Nice-to-haves • MBA, MPH and/or JD preferred. • Experience in the Missouri health insurance market strongly preferred. • Excellent network development, contracting, analytical and negotiation (listening) skills. • Proven strategic provider partnership experience. • Value-Based contracting expertise and performance management experience. • Proven experience developing relationships both internal to the organization and external client facing. Benefits • 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.
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