Program Director - Out-Of-Network Repricing

Elevance HealthAtlanta, IN
10hHybrid

About The Position

Program Director - Out-Of-Network Repricing Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Program Director will be responsible for the development and ongoing management of the Anthem Health Plan Out-Of-Network repricing program. This is an external client facing programs that is multi-state, multi-function and multi-year in scope. The Program director will oversee Out-of-Network strategy, operations, and support client facing interactions. How you will make an impact: Directs the development, planning, prioritization, approval, implementation and compliance of on-going external client facing programs Establishes program governance when needed to assure response to issue escalation; develops program budget and ensures program meets its stated objectives Provides subject matter expertise in response to day to day business issues; researches applicable subject matter practices; and remains aware of industry trends Manages external client facing relationships and partners with corporate and regional business areas Develops communication documents and training criteria related to external client facing program success measures Develops documentation to support meeting presentations and the tracking and reporting of the program’s success Provides leadership to program managers and project managers

Requirements

  • Requires a BA/BS and minimum of 10 years experience in external client facing program management, project management; complex business processes, strategic and business planning; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

  • Experience with OON repricing programs at payor or vendor.
  • MBA preferred.
  • Project management certification (PMP).

Responsibilities

  • Directs the development, planning, prioritization, approval, implementation and compliance of on-going external client facing programs
  • Establishes program governance when needed to assure response to issue escalation; develops program budget and ensures program meets its stated objectives
  • Provides subject matter expertise in response to day to day business issues; researches applicable subject matter practices; and remains aware of industry trends
  • Manages external client facing relationships and partners with corporate and regional business areas
  • Develops communication documents and training criteria related to external client facing program success measures
  • Develops documentation to support meeting presentations and the tracking and reporting of the program’s success
  • Provides leadership to program managers and project managers

Benefits

  • In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
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