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Staff VP Provider Strategy & CoC Performance

N/A, USA | Anthem

  • Industry:
    Insurance - Health & Life
  • Position Type:
  • Functions:
  • Experience:
    15-20 years
Job Description:
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Responsibilities would include working in many aspects of COC overall. Areas that this role will be an integral part of is the Contract Administration area helping to formulate and executing efficient processes, getting EFA/EPA into Contrax, Emptoris (GBD) to Contraxx by year end, and putting together a strategy playbook for contract managers to have an E2E view on Contraxx. This role would also be working on CoC execution and strategy as well as being a very integral part in the Chargemaster enforcement unit. Additionally, this role will be responsible for application of external market best practices to enhance competitive position in the market. In the area of COC, her a playbook needs to be created on who and what and various value drivers. 

Primary duties may include but are not limited to: 

Helping the overall process and getting 100% of Legacy Commercial Hospital Agreements where the Hospital Agreement is not in Contraxx, into Contraxx by YE. Inclusion of Large Physician Groups currently not in Contraxx will also occur. All reporting functionality available, PADU reporting.

Establish a strategy playbook on all COC processes to identify key contacts, drive collaboration across multiple departments/functions, and to improve efficiencies in order to achieve our cost of care target for the organization.

Be an integral person in managing the Chargemaster Enforcement Unit and delivering COC value.

Supporting overall COS type responsibilities for COC/Contract Administration/National Contracting/EAP/BH.

Help develop a vision of implementing a Capitation unit across the enterprise, dealing with all LOBs.

Requires Bachelor’s Degree in related field.

15+ years’ experience in E2E work, Contract Administration, COC work, understanding of external payer views and visions.

Any combination of education and experience, which would provide an equivalent background.

Master’s Degree in related field preferred.

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