Anticipated End Date:

2024-08-25

Position Title:

Regional Vice President (RVP) Provider Solutions

Job Description:

Regional Vice President (RVP) Provider Solutions

Location: Miami, FL or Tampa, FL.

Summary:

The Regional Vice President (RVP) of Provider Solutions will be responsible for strategic leadership over all provider engagement and contracting activity throughout Florida, including cost of care and trend management strategy, hospital negotiations, network and product design (implementation), and development/oversight of all payment innovation programs (value-based care), provider relations and primary care growth strategy throughout the state. The position holds leadership and end-to-end responsibility over Simply Healthcare, HealthSun Health Plans, Freedom Health and Optimum Healthcare (American First Choice) network development activities on behalf of multiple P&Ls.

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 Florida, 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 unique (non-traditional) incentives into the overarching contracting process, shepherding 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 approximately ~150 direct report associates (directors, managers, analysts, individual contributors).

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 relationships both internal to the organization and external client facing.

• Experience in the Florida health insurance market.

• Spanish and English written and literary proficiency strongly preferred.

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 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. 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 [email protected] for assistance.