Anthem, Inc. Hiring for Provider Reimbursement Manager at Reston, Virginia Full Time

Description

SHIFT: Day Job

SCHEDULE: Full-time

Provider Reimbursement Manager

Manages key components of the provider reimbursement strategy.

Work from home anywhere in U.S. (Prefer: IN, GA, VA, PA, WA, TX, FL)

Primary duties may include, but are not limited to:

• Leads fee schedule development for specific plan(s) and/or the development and implementation of clinical editing rules.

• Works with the Health Service Area, actuarial, decision support, and underwriting to ensure that accurate cost of care targets are incorporated into product pricing and the company’s financial plans.

• Performs and/or directs complex fee modeling exercises to ensure that projected unit reimbursement changes meet corporate cost targets.

• Provides analytical support for hospital and physician negotiations.

• Prepares and presents cost of care data analysis to support the regions cost of care initiatives.

• Develops and maintains the provider reimbursement strategy that will lower the cost of care, improve service, and reduce administrative expenses.

• Provides technical support and operational direction to junior analysts while supporting the leadership team on key performance goals and reaction to emerging issues.

Qualifications

Requires:

• BA/BS degree in a related field;

• 7+ years reimbursement experience including performing detailed financial modeling and economic analyses; or any combination of education and experience, which would provide an equivalent background.

  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.

  REQNUMBER: PS57352-Virginia