Anthem, Inc. Director, Network Management (Contracting and Strategy) in Melville, New York
SHIFT: Day Job
Empire BlueCross BlueShield is hiring a Director of Network Management.
Who is Empire? As one of the leading healthcare companies in the New York area, Empire BlueCross BlueShield’s mission is to improve the health of every New Yorker. We are a proud member of the Anthem Inc. family of companies and work to lead the industry through innovation and care. Come join us on our mission and together we will transform the future of health. This is an exceptional opportunity to do innovative and meaningful work.
At Empire, our providers are at that center of what we do. We work in partnership with the provider community to make an impact on the total health and well-being of New Yorkers and their daily lives. Your contributions to creating and maintaining that leading network will help us to achieve our goals.
We’ve been serving New Yorkers for 80 years, Empire BlueCross BlueShield is the largest health insurer in New York supporting more than four million members and more than 38,000 business, union and small employers in New York.
This position can be located in one of the following Anthem office locations:
New York, NY; Melville, NY; Middletown, NY
As the Director of Network Management, you will responsible for about $3-5B in provider (or health system / hospital) revenue across the company's Medicare, Medicaid and Commercial lines of business. Your efforts would have a substantial impact on Empire’s bottom line.
As a member of the NY network leadership team, you will design and deliver on Empire’s core business plan and initiatives for the New York City and Long Island Markets.
Primary duties may include, but are not limited to:
• Identify new process improvement opportunities across Empire’s network operations divisions, mission-driven to deliver an unparalleled provider service experience.
• Help to design new network solutions and product benefit offerings in conjunction with Empire’s account management, sales and operations areas.
• Manage an annual financial budget and oversee the effective distribution of cost increase targets throughout the Greater New York area.
• Oversee contracting, negotiations and maintenance of all facility relationships including hospitals, surgery centers and employed physician practices.
• Institute new cost containment strategies in way of lowering the overall cost of medical care for Empire’s clients and members.
• Oversee the development, maintenance and reconciliation of hospital risk contracts and value-based reimbursement arrangements in accordance with growth priorities.
• Attract, develop and manage key contracting and servicing staff, providing mentorship and guidance to other associates.
• Develop innovative ways to maintain a cost effective network with adequate access and positive working relationships across Empire’s providers.
• As the Director of Network Management, you will hire, train, coach, counsel, and evaluate the performance of direct team of up to 20 people.
What you will need to qualify for the role:
• You have a genuine, sincere desire to transform healthcare and make a difference in our industry.
• You have earned a BS/BA degree in business administration or related healthcare field.
• You have a minimum of 8 years of direct work experience in healthcare operations, finance, underwriting, actuary, network development and sales experience; or any combination of education and experience, which would provide an equivalent background. We will rely on you for your expertise in these areas to help us grow!
If you have these, that’s a plus:
• MPH or MBA preferred (if you have a relevant Master’s degree, minimum years of experience needed may be 6)
Empire BlueCross BlueShield (Empire) is the trade name of Empire HealthChoice Assurance, Inc., and Empire Blue Cross Blue Shield HMO is the trade name of Empire HealthChoice HMO, Inc., independent licensees of the Blue Cross Blue Shield Association, serving residents and businesses in the 28 eastern and southeastern counties of New York State. Additional information about Empire is available at www.empireblue.com. Also, follow us on Twitter at https://twitter.com/empirebcbs
As a member of the Anthem, Inc. family, you will are eligible for a comprehensive, flexible benefits package as part of our Total Rewards program. Through our Total Rewards program, you can tailor your benefits package to meet your particular needs and budget; you can find more here https://anthemcareers.ttcportals.com/pages/associate-benefits