Regional Vice President (RVP) Provider Solutions II

Anticipated End Date:

2025-06-08

Position Title:

Regional Vice President (RVP) Provider Solutions II

Job Description:

Anthem Blue Cross and Blue Shield is a proud member of the Elevance Health family of companies offering Medicare plans, Medicaid, individual and family plans, and group insurance plans in Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, Ohio, Virginia and Wisconsin. Our group plans include a variety of group medical, pharmacy, dental, vision, life and disability plans flexible enough to fit any size business.

Regional Vice President (RVP) Provider Solutions II

Location

Virginia (Richmond, Norfolk or Roanoke)

Summary

The Regional Vice President (RVP) of Provider Solutions is a dynamic and results-oriented leader committed to healthcare transformation through strategic leadership over all provider engagement and contracting activity in the Virginia market. The RVP of Provider Solutions spearheads cost of care and trend management strategy, leads/closes impactful hospital negotiations, and drives/evolves a comprehensive primary care growth strategy throughout the market.  This role will offer expert insight to the development/execution of payment innovation programs (value-based care) and a proven track record of relationship management/account management excellence for enhanced provider relations. As an RVP, this individual is charged with end-to-end responsibility over ambitious network and product design (implementation) while championing initiatives on behalf of multiple P&Ls.

Team Scope

7 direct reports / 50 total FTE’s

Position Responsibilities

Primary duties may include, but are not limited to:

• Oversees and continuously optimizes the local-market care delivery model, seeking and identifying new opportunities to enhance, enable and improve market provider account management expertise and the overarching provider experience.

• Delivers competitive cost-of-care trends throughout Virginia, positively impacting the affordability of respective Medicaid and Medicare Advantage health plan products.

• Develops new provider networks that establish a competitive advantage, optimizing respective provider relationships to most effectively benefit health plan growth priorities.

• Aligns contracting decisions with medical management strategy, integrating quality metrics and inventive (non-traditional) incentives into the overarching contracting process, championing a market transition from “fee-based” reimbursement to a model based on quality achievement.

• Ensures compliance with all regulatory and accreditation standards (local and federal).

• Collaborates with Product Development to recommend and implement innovative benefit plan designs in parallel with annual planning processes.

• Mentors, hires, trains, coaches, counsels, and evaluates the performance of a multidisciplinary team of approximately ~100 direct report associates (directors, managers, analysts, individual contributors).

• Champions digital connectivity and information interoperability initiatives with key provider and health system partners, intended to simplify the payment of healthcare and streamline operations.

Position Requirements

BS/BA in business administration or related healthcare field and a minimum of 10 years of experience in healthcare operations, finance, underwriting, actuary, network development, and/or sales; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• MBA, MPH and/or JD preferred.

• Excellent contracting, analytical and negotiation (listening) skills needed.

• Proven strategic provider partnership experience.

• Value-Based contracting expertise and performance management experience.

• Proven experience developing and maintaining meaningful relationships both internal to the organization and external client facing.

• Experience in the Virginia health insurance market.

Job Level:

Staff/Regional VP

Workshift:

Job Family:

PND > Network Contracting

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 comp