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Job Family: Provider Network Management
Req #: PS43111
Date Posted: Jan 26, 2021
DescriptionSHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to 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 care companies and a Fortune Top 50 Company.
Provider Network Mgr I
Tampa - Florida
Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with less complex providers which may include, but are not limited to, professional providers, practice groups, small medical groups, providers in less competitive markets, and providers with greater familiarity with managed care concepts. 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. Primary 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.
Requires a BA/BS degree; 2 years experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background. Requires travel.
Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.