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Description SHIFT: Day JobSCHEDULE: Full-timeResponsible for Payment Innovation/payment model business solution research, design, development and ongoing strategy. Responsible for the implementation and ongoing support of Medicaid Social Determinants of Health provider incentive program across 17 States in 2021. Provides same support for a new Substance Use Disorder Facility incentive program and an Emergency Department Behavioral Health provider incentive program. These programs are impact cost of care, quality improvement and success in RFP Medicaid expansion bids. Primary duties may include, but are not limited to: Conceives innovative payment solutions for healthcare providers thru provider collaboration, providing guidance on the development of payment systems and how provider contracting drives provider behavior.
Analyzes market and competitive data, supports collection of business requirements, business case and ROI analysis. Works with business owner and other business partner to develop Payment Innovation solutions, pilot and launch strategic activities.
Supports engagements with provider technical and clinical teams and Anthem cross functional teams.
Contributes to the creation of roadmaps through the Anthem Wave process.
Makes pragmatic decisions as a business owner and constantly evolves the solution to meet the needs of the company and the provider in support of the value based care payment models and special projects.
Qualifications Requires a BA/BS in business or related field; and 5 years of experience in healthcare systems, including 3 years of experience in a strategic role; or any combination of education and experience, which would provide an equivalent background. MBA preferred. Previous experience with value based care programs, provider incentives, and payment innovation preferred. Project and/or program management experience desired.AnEqualOpportunityEmployer/Disability/VeteranREQNUMBER: PS42776
