Provider Network Manager, Sr. (Behavioral Health)
DescriptionSHIFT: Day Job
Job Title: Provider Network Manager, Sr.
Location: 100% Remote/ Work from Home (Though this role is remote, we can only consider candidates familiar with the New Mexico Market and residing in the following states: Colorado, New Mexico, Arizona, Utah, Texas).
Travel: About 30% of travel, within perspective markets, is required in the role.
Hours: Monday-Friday (8am - 5 pm MST)
Be part of an extraordinary team!
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Build the Possibilities. Make an extraordinary impact.
Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Beacon Health Options is a proud member of the Anthem Inc family of companies.
How you will make an impact:
Develops the behavioral health provider network through contract negotiations, relationship development, and servicing. The primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value-based concepts understanding and support, 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 customized.
Primary duties may include, but are not limited to:
- Serves as a key resource for other contracting staff and provides mentoring and on-the-job training and development.
- Works independently and requires a high level of judgment and discretion.
- May work on projects and reports impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
- May collaborate with the sales team in making presentations to employer groups.
- Serves as a communication link between professional providers and the company.
- Ensure that network composition includes an appropriate distribution of provider specialties.
- Conducts more complex negotiations and drafts documents.
- Prepare financial projections and conduct analysis.
Applicable to Colorado Applicants Only
Annual Salary Range*: $86,000- $112,875
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
* The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Requires a BA/BS degree and a minimum of 5 years of experience in contracting, provider relations, and provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background. Experience in fee schedule development using actuarial models,
Preferred Skills, Capabilities and Experiences:
- Understanding of behavioral health systems of care and knowledge of the New Mexico markets is strongly preferred.
- Ability to commute up to 30% of the time
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, 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.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state, and local laws.
Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem 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.
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.