Job Information

Anthem, Inc. Provider Reimbursement Director in Norfolk, Virginia


SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.

Provider Reimbursement Director

Work Location - Virginia

Leads key provider reimbursement functions and initiatives across the enterprise and serves as subject matter expert regarding provider reimbursement strategies and practices. Primary duties may include, but are not limited to:

· Leads the development and implementation of enterprise-wide provider reimbursement strategies, processes and systems for a major provider type, such as facilities.

· Works to drive the adoption and use of standardized reimbursement and contracting methodologies across the enterprise.

· Works with medical directors, contract negotiators, cost of care staff and provider relations staff to identify and implement best practice solutions to manage costs and reimburse for services.

· Facilitates the communication of activities, emerging trends, and best practices across all units and facilitates implementation of initiatives, through use of a steering committee containing representatives from the company's plans, regions, and business units.

· Researches and quantifies the impact of changes to reimbursement methodologies.

· May lead fee schedule development for specific plan(s) and/or the development and implementation of clinical editing rules.

· Manages special projects and initiatives.

· Represents the department and serves as a key contributor on enterprise initiatives, projects, and task forces.

Requires a BS/BA degree in a related field; 10 + years business and professional experience in provider reimbursement and contracting, provider relations, and provider servicing; or any combination of education and experience, which would provide an equivalent background. Masters degree preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.