Vacancy caducado!
Provider Network Manager I, II, or Sr - Any Anthem Office (Woodland Hills, CA Preferred) - PS 20350Location: United StatesNewField: Provider Network ManagementRequisition #: PS20350Your 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 atone of America's leading health benefits companies and a
Fortune Top 50 Company.Provider Network Manager I, II, SrLocation: Any Anthem Office (Woodland Hills, CA Preferred)Manages enterprise ancillary contracting efforts
across all lines business to include Medicare and Medicaid, to provide
a competitive advantage and deliver
competitive cost of care trends. Primary duties include, but are not limited
to:Provider Network Manager is responsible for developing the provider network
through contract negotiations, relationship development, and
servicing. Primary focus of this role is
contracting and negotiating contract terms.
Contracts tend to be more standard and afford lessopportunity for customization.
Fee schedules are fairly standardized with reimbursement models limited andwell-defined.
May participate in intradepartmental projects or smaller projects impactingmultiple departments.
Operates with general supervision, elevating unusual situations tomanagement as required.
Negotiates single case agreements, tracks and reports on a monthly basis.
Essential duties may include, but are not limited
to:
Solicits participation in the network andconducts re-contracting efforts as needed.
Serves as a communication link between professional providers and thecompany.
Conducts limited negotiations and drafts documents.
Assists in preparing financial projections as required.
Performs other duties as assigned.
Provider Network Manager II is responsible for developing the provider network
through contract negotiations, relationship development, and
servicing. Primary focus of this role is
contracting and negotiating contract terms. This level typically works with more
complex providers at least 50% of
the time. Complex
providers may include, but are not limited to, smaller institutional providers,
professional providers with more complex contracts, medical
groups, ancillary providers, providers in areas with increased competition or
where greater provider education around managed care concepts is
required.
Contracts may involve non-standard arrangements that require a moderatelevel of negotiation skills.
Fee schedules can be customized.
Works with increased independence and requires increased use of judgment anddiscretion.
Serves as resource for lower-leveled consultants.
May work on cross-functional projects requiring collaboration with other keyareas.
May collaborate with sales team in making presentations to employergroups.
Negotiates single case agreements, tracks and reports on a monthly basis.
Essential duties may include, but are not limited
to:
Serves as a communication link between professionalproviders and the company.
Conducts more complex negotiations and draftsdocuments.
Assists in preparing financial projections and conducting analysis asrequired.
Performs other duties as assigned.
Provider Network Mgr Sr. is responsible for developing the provider network
through contract negotiations, relationship development, and
servicing. Primary focus of this role is
contracting and negotiating contract terms. This level typically works with the
most complexproviders at least 50% of the time. Complex
providers may include, but are not limited to institutional
providers, professional providers with
complex contracts, medical groups, ancillary providers, providers in areas with
strong competition or where greater
provider education around managed care concepts is required.
Contracts involve non-standard arrangementsthat require a high level of negotiation skills.
Fee schedules are often customized.
Serves as key resource for other contracting staff and provides mentoringand on-the-job training and development.
May serve as lead over a contracting team engaged in less complexnegotiations. Works independently and requires high level of judgment anddiscretion.
May work on cross-functional projects requiring collaboration with other keyareas or serve on enterprise projects around network management as needed.
May collaborate with sales team in making presentations to employergroups.
Negotiates single case agreements, tracks and reports on a monthly basis.
Essential duties may include, but are not limited
to:
Serves as a communication link between providers andthe company.
Conducts more complex negotiations and drafts documents.
May prepare financial projections and conduct analysis asrequired.
Provider Network Manager IRequires BA/BS and 2 years’ experience in contracting, provider relations,
provider servicing or any combination of education and experience that would
afford equivalent competencies.
Ancillary contracting experience preferred.
Must have strong oral and written communication skills, good analyticalskills, and PC skills.
Experience in market and network analysis preferred.
Experience developing reimbursement and contracting strategiespreferred.
Requires travel.
Provider Network Manager IIRequires BA/BS, Masters degree preferred, and 3-5 years experience in
contracting, provider relations with an emphasis on Medicaid operations,
provider servicing or any combination of education and experience that would
afford equivalent competencies.
Ancillary contracting experiencepreferred.
Must have strong oral and written communication skills, good analyticalskills, and PC skills.
Experience in market and network analysis preferred
Experience developing reimbursement and contracting strategiespreferred.
Requires travel.
Provider Network Mgr Sr.Requires BA/BS and 5-7 years experience in contracting, provider relations
with an emphasis on Medicaid operations, provider servicing or any combination
of education and experience that would afford equivalent competencies.
Ancillary contracting experience preferred.
Experience should include prior contracting experience.
Must have exceptional oral and written communication skills, stronganalytical skills, and PC skills.
Must demonstrate leadership skills.
Requires travel.
Please note, we currently have one opening for this position and level will
be determined upon candidate's skills, experience and education.Anthem, Inc. is ranked as one of America’s Most Admired Companiesamong health insurers by Fortune magazine and is a 2018 Diversity Inc magazineTop 50 Company for Diversity. To learn more about our company and apply, pleasevisit us at careers.antheminc.com. An Equal OpportunityEmployer/Disability/Veteran.