Contract Optimization Advisor (Louisville, KY) - 65243 PI
WellPoint - Louisville, KY

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Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to improving the lives of the people we serve and the health of our communities.

Bring your expertise to our innovative, achievement-driven culture, and you will

discover lasting rewards and the opportunity to take your career further than you can imagine.

Payment Innovation Overview

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 to 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.

        Contract Optimization Advisor

        Responsible for providing operational and administrative support for Payment Innovation initiatives (e.g., Patient Centered Primary Care, Patient Centered Medical Homes, Accountable Care Organizations). Primary duties may include, but are not limited to: internal coordination and collaboration with Provider Network, Medical Management, Analytics, and others to meet provider and practice service needs, external outreach to support assigned provider practices/contracts including implementation and ongoing maintenance of these innovative programs. Obtains and analyzes quality metrics, creates reports, and assists in identifying and tracking action plans designed to address cost, quality, and the member experience. Participates in design, development, and implementation of community learning forums. Maintains up to date knowledge on Patient Centered Medical Home, Care Delivery System Redesign, and Accountable Care Organizations.

        Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to improving the lives of the people we serve and the health of our communities.

        Bring your expertise to our innovative, achievement-driven culture, and you will

        discover lasting rewards and the opportunity to take your career further than you can imagine.

        Payment Innovation Overview

        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 to 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.

        Contract Optimization Advisor

        Responsible for providing operational and administrative support for Payment Innovation initiatives (e.g., Patient Centered Primary Care, Patient Centered Medical Homes, Accountable Care Organizations). Primary duties may include, but are not limited to: internal coordination and collaboration with Provider Network, Medical Management, Analytics, and others to meet provider and practice service needs, external outreach to support assigned provider practices/contracts including implementation and ongoing maintenance of these innovative programs. Obtains and analyzes quality metrics, creates reports, and assists in identifying and tracking action plans designed to address cost, quality, and the member experience. Participates in design, development, and implementation of community learning forums. Maintains up to date knowledge on Patient Centered Medical Home, Care Delivery System Redesign, and Accountable Care Organizations.

        WellPoint - 15 months ago - save job - block
        About this company
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        WellPoint, Inc. (WellPoint) is a health benefits company serving 35 million medical members, as of December 31, 2008. The Company is an...