Strategic Provider Account Director
Current-Operates as the primary point of contact and central interface between strategic healthcare delivery systems, provider groups, and Elevance Health’s internal stakeholders-Owns the relationship end-to-end, post-contract, for strategic initiatives and execution of core growth tactics for a defined set of strategic provider partners across Elevance Health for all business segments-Assists strategic provider groups with complex operating structures such as value-based payment arrangements and diverse integration/risk contracting strategies by fully understanding their operating/business models and proactively identifying provider needs and recommending solutions-Selected as Colorado’s market champion for Epic Payer Platform, as part of Anthem’s enterprise focus on digital innovation-Proposes ways to improve existing relationships through best-practices, and identifies opportunities to increase cost of care savings as well as the provider group’s performance in quality-of-care indicators-Manages the relationship and provides leadership to a matrixed internal team accountable for contracting, value-based payments, account management, claims processing and operations issue resolution, as well as care delivery transformation support, provider enablement, and clinical subject matter experts-Responsible for monitoring contract performance, including performance on HEDIS measures, Star Ratings, CoC, and additional areas of opportunity -Accountable for strategy in the resolution and escalation of issues and barriers to success; engages appropriate internal matrixed resources to deliver on escalated service issues and appropriate process improvement initiatives-Leads executive steering committees and joint operating forums-Coordinates communications strategy on such issues as administrative and medical policy, contract reimbursement changes, and provider utilization patterns