This position may be in any WellPoint location or telecommute.
WellPoint’s Payment Innovation team is focused on reforming our current healthcare delivery system. Despite having the most costly health system in the world, the U.S. health care system ranks last or next-to-last on five dimensions of a high performing health system. As stewards of our customer’s healthcare dollar, Anthem’s goal is to drive improvements in the system that changes this picture through arrangements with our providers that:
– rationalize the connection between price, cost and value with a focus on quality and the total cost of care
– move away from the current, unsustainable, model that rewards volume over value.
– create the right incentives to foster – and enable – hospitals, health system, physicians and other providers make the right decisions based on community need and evidence based standards of quality and appropriate care.
Anthem is committed to migrating from volume to value based provider payment arrangements. This commitment is evidenced by our large and successful portfolio of payment innovation arrangements, including hospital and physician Pay for Performance programs, Bundle Payment arrangements, Accountable Care models, Patient Centered Medical Homes, and Chronic Care Models. This position plays a critical role in supporting one or more of these payment innovation arrangements
Responsible for managing the relationship between the Patient Centered Care organization and product development in the development and implementation of Ambulatory Intensive Care Units (AICU)/Chronic based products for the Commercial, Individual, Senior and Medicaid businesses. Primary duties may include, but are not limited to: Serves as the operational subject matter expert for the AICU/Chronic based products development and implementation. Addresses product team needs within the delivery system and ensures the services delivered are consistent and integrated across the delivery sites. Ensures the products are being executed across the delivery network as designed and are delivering the anticipated performance. Identifies and develops plans to address gaps and works with business leaders and the product design team to ensure that operations successfully delivers on the intended results.
Requires a BA/BS; 8+ years of related health care experience; or any combination of education and experience, which would provide an equivalent background. MBA in health or business related field preferred. Knowledge of care management operations and/or clinical background preferred (i.e. vendor health plan care management, Physicians office, etc.). Proficiency in Word, Excel, PowerPoint required. Strong verbal and written communication skills required. Experience with reimbursement arrangements and physician relationship experience a plus. Travel required.
WellPoint is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, one of the 100 Best Places to Work by Working Mother magazine, and is a 2011 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at
Once an offer is accepted, all external applicants are subject to a background investigation
and if appropriate, drug testing. Offers of employment shall be contingent upon
passing both the background investigation and drug testing (if required).
associate referral process on WorkNet. Official guidelines for the associate referral
- Current WellPoint associates: All referrals must be submitted through the formal
program can be found in My HR.
American Imaging Management - 12 months ago
WellPoint, Inc. (WellPoint) is a health benefits company serving 35 million medical members, as of December 31, 2008. The Company is an inde...