Vacancy caducado!
Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Empire Blue Cross Blue Shield, a proud member of the Anthem, Inc. family of companies, 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.This position can be
located in one of the following Anthem office locations: New York, NY; Melville,
NY; Albany, NY (2 positions available)At
Empire, our providers are at that center of what we do. We understand our
health connects us to each other. What we all do impacts those around us. So
Empire is dedicated to delivering better care to our members.Manager, Provider Network Management (Physician Negotiations): This role manages provider network contracting and negotiations in
downstate New York (Westchester, New York City, Long Island). Primary duties
may include, but are not limited to:
Effectively manages a team of contractors
and network consultants to meet and exceed financial trend targets for
Commercial, Medicare and Medicaid lines of business.
Develops reimbursement
models and negotiates renewal agreements with large professional groups and
independent provider associations (IPAs).
Responsible for allocating a defined
budget according to professional service type, and by Primary Care and
Specialty practice subsets.
Manage contracts within budget constraints while
maintaining positive working relationships with Empire’s professional provider
base.
Responsible for the development of contracting models, provider
reimbursement strategies, and renewal modeling.
Hires, trains, coaches,
counsels, and evaluates performance of direct reports (approximately 8).
Manager, Provider Network Management (Physician Contracting and Administration): The role manages key provider network administrative and service
functions across Empire’s full operating footprint. Primary duties may include,
but are not limited to:
Leads ongoing network maintenance functions and
overarching relationship management for a broad base of independent provider
practices.
Develops and leads special network projects such as provider
recruitment efforts, credentialing / re-credentialing processes and oversight
of new network builds.
Must have a passion for strong service and the ability
to manage through business / process change.
Hires, trains, coaches, counsels,
and evaluates performance of direct reports (approximately 10).
Qualifications Requires a BA/BS degree in a related field; 5+ years
equivalent work experience in provider contracting; or any combination of
education and experience, which would provide an equivalent background.Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2019 DiversityInc 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.REQNUMBER: PS36573-Melville-Melville
Vacancy caducado!