Anthem Provider Network Manager I - Woodland Hills, CA / San Diego, CA (Office Based) - PS7798 in San Diego, California
Provider Network Manager I - Woodland Hills, CA / San Diego, CA (Office Based) - PS7798
Location: Woodland Hills, California, United States
Field: Provider Network Management
Requisition #: PS7798
Post Date: Jul 13, 2018
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.
Manages enterprise ancillary contracting efforts,with a focus on Commercial Health Plans, that provide a competitive advantage and deliver competitive cost of care trends. Primary duties include, but are not limited to:
Provider Network Manager I
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.
Provider Network Manager I
Requires a BA/BS degree; 2 years experience in contracting, provider relations with an emphasis on commercial healthcareoperations, provider servicing or any combination of education and experience that would afford equivalent competencies.
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 in the healthcare setting preferred.
Requires 10% - 15% local travel required.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.