Provider Collaboration Director-Tennessee
Elevance Health
**Provider Collaboration Director-Tennessee**
**Location:** This position will work a hybrid model (remote and office). Ideal candidate will reside within 50 miles/1 hour commute of the posted Elevance Health location.
The **Provider Collaboration Director** is responsible for enhancing cost efficiency and quality outcomes for the management of Enhanced Personal Health Care (EPHC), payment innovation, and collaborative programs across all business lines in the Tennessee market.
**How you will make an impact:**
+ Responsible for identifying provider targets, negotiating competitive participation agreements, and support providers in improving cost of care and HEDIS Star performance for attributed populations.
+ Facilitate performance focused internal and external standing meetings.
+ Drives medical and behavioral health integration initiatives.
+ Function as company's SME in payment innovation and collaboration programs.
+ Identifies payment innovation gaps and engages appropriate resources for solution.
+ Collaborates with Care Consulting, Pharmacy, and Risk Adjustment teams to drive Cost of care and HEDIS Star performance.
+ Guides providers to move into more mature payment programs.
+ Conducts discussions with employer groups and health system executives.
**Minimum Qualifications:**
+ Requires a BA/BS degree and a minimum of 8 years’ experience in contracting (value based, shared savings and Accountable Care Organization (ACO) development), provider relations, provider servicing; experience must include prior contracting experience; prior experience with oversight and responsibility of regulatory requirements for line of business supported; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities and Experiences:**
+ Experience using financial models and historical cost and quality performance data to negotiate preferred and acceptable deal terms.
+ Ability to understand and implement complex value-based, partial, and full risk contracts.
+ Experience in Medicare and Medicaid value-based negotiation and contracting
+ Strongly prefer knowledge of Tennessee provider networks, including PCPs and hospital systems.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
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.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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