Job Details

Provider Network Manager I II or Sr. Ancillary Contracting - Any Anthem Office - PS18460

Company name
Anthem, Inc.

Location
Lubbock, TX, United States

Employment Type
Full-Time

Industry
Manager, Work At Home

Posted on
Mar 08,2019

Valid Through
Jun 21,2019

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Profile

Provider Network Manager I, II, or Sr. (Ancillary Contracting) - Any Anthem Office - PS18460

Location: United States

New

Field: Provider Network Management

Requisition #: PS18469

Post Date: 5 hours ago

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Location: Any Anthem Office with ability to work from home.

Manages enterprise ancillary contracting efforts across all lines business to include Medicare and Medicaid, to provide a competitive advantage and deliver competitive cost of care trends. Primary duties include, but are not limited to:

Provider Network Manager I

Responsible for developing the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms.

Contracts tend to be more standard and afford less opportunity for customization.

Fee schedules are fairly standardized with reimbursement models limited and well-defined.

May participate in intradepartmental projects or smaller projects impacting multiple departments.

Operates with general supervision, elevating unusual situations to management as required.

Essential duties may include, but are not limited to:

Solicits participation in the network and conducts re-contracting efforts as needed.

Serves as a communication link between professional providers and the company.

Conducts limited negotiations and drafts documents.

Assists in preparing financial projections as required.

Performs other duties as assigned.

Provider Network Manager II

Responsible for developing the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. This level typically works with more complex providers at least 50% of the time. Complex providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required.

Contracts may involve non-standard arrangements that require a moderate level of negotiation skills.

Fee schedules can be customized.

Works with increased independence and requires increased use of judgment and discretion.

Serves as resource for lower-leveled consultants.

May work on cross-functional projects requiring collaboration with other key areas.

May collaborate with sales team in making presentations to employer groups.

Essential duties may include, but are not limited to:

Serves as a communication link between professional providers and the company.

Conducts more complex negotiations and drafts documents.

Assists in preparing financial projections and conducting analysis as required.

Performs other duties as assigned.

Provider Network Mgr Sr.

Responsible for developing the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. This level typically works with the most complex

providers at least 50% of the time. Complex providers may include, but are not limited to institutional providers, professional providers with complex contracts, medical groups, ancillary providers, providers in areas with strong competition or where greater provider education around managed care concepts is required.

Contracts involve non-standard arrangements that require a high level of negotiation skills.

Fee schedules are often customized.

Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.

May serve as lead over a contracting team engaged in less complex negotiations. Works independently and requires high level of judgment and discretion.

May work on cross-functional projects requiring collaboration with other key areas or serve on enterprise projects around network management as needed.

May collaborate with sales team in making presentations to employer groups.

Essential duties may include, but are not limited to:

Serves as a communication link between providers and the company.

Conducts more complex negotiations and drafts documents.

May prepare financial projections and conduct analysis as required.

Provider Network Manager I

Requires BA/BS and 2 years’ experience in contracting, provider relations, provider servicing or any combination of education and experience that would afford equivalent competencies.

Ancillary contracting experience preferred.

Must have strong oral and written communication skills, good analytical skills, and PC skills.

Experience in market and network analysis preferred.

Experience developing reimbursement and contracting strategies preferred.

Requires travel.

Provider Network Manager II

Requires BA/BS, Masters degree preferred, and 3-5 years experience in contracting, provider relations with an emphasis on Medicaid operations, provider servicing or any combination of education and experience that would afford equivalent competencies.

Ancillary contracting experience preferred.

Must have strong oral and written communication skills, good analytical skills, and PC skills.

Experience in market and network analysis preferred

Experience developing reimbursement and contracting strategies preferred.

Requires travel.

Provider Network Mgr Sr.

Requires BA/BS and 5-7 years experience in contracting, provider relations with an emphasis on Medicaid operations, provider servicing or any combination of education and experience that would afford equivalent competencies.

Ancillary contracting experience preferred.

Experience should include prior contracting experience.

Must have exceptional oral and written communication skills, strong analytical skills, and PC skills.

Must demonstrate leadership skills.

Requires travel.

Please note, we currently have one opening for this position and level will be determined upon candidates’ skills, experience and education.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

Company info

Anthem, Inc.
Website : http://www.antheminc.com

Company Profile
The company was formed when WellPoint Health Networks Inc. and Anthem, Inc. merged in 2004 to become the nation's leading health benefits company. The parent company originally assumed the WellPoint, Inc. name at the time of the merger. In December 2014, WellPoint, Inc. changed its corporate name to Anthem, Inc. The Anthem brand is built on a foundation of trust – it’s the name consumers are most familiar with as a trusted health care partner through our affiliated health plans. Anthem, Inc. is one of the largest health benefits companies in the United States. Through its affiliated health plans, Anthem companies deliver a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, Anthem, Inc. is an independent licensee of the Blue Cross and Blue Shield Association serving members in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin; and specialty plan members in other states.

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