Provider Network Mgr I
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.
- 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 and a minimum of 2 years experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.
- Requires travel.
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.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
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.