Anthem Network Relations Consultant / Consultant Sr - East TN Area or Bordering Areas NC, GA and VA Required - Remote Work Available - PS12778 in Arlington, Virginia

Network Relations Consultant / Consultant Sr - East TN Area or Bordering Areas NC, GA and VA Required - Remote Work Available - PS12778

Location: Tennessee, United States

Field: Provider Network Management

Requisition #: PS12778

Post Date: Nov 05, 2018

Your Talent. Our Vision. At Amerigroup , a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals,it’s a powerful combination. It’s 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 .

Develops and maintains positive relationships with providers and develops strategies for recruitment and contracting.

Primary duties may include, but are not limited to:

  • Develops and maintains positive relationships with the provider community by periodic on-site visits, communicating administrative or programmatic changes and facilitating the resolution of provider issues.

  • Recruits providers to build a cost effective, high quality provider network. Conducts negotiations and leads contracting efforts with providers to build and maintain a cost effective, accessible provider network.

  • Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.

  • Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.

  • Conducts seminars to support the understanding of managed care and Amerigroup policies and procedures.

  • Identifies network access and deficiencies and develops recruitment and contracting strategies.

  • Coordinates and conducts provider training.

Candidate must reside within a reasonable commute distance from East TN (Bordering Areas NC, GA and VA may be considered.

Network Relations Consultant (Provider Relations)

  • Requires a BA/BS degree; 3 years of related experience (provider relations, network management, provider customer service, sales-negotiation); prior negotiation experience; or any combination of education and experience, which would provide an equivalent background.

  • Excellent written and verbal communication skills required.

  • Medicaid experience preferred.

  • 50% local travel in East TN required.

Network Relations Consultant Sr. (Provider Relations):

  • Requires a BA/BS degree; 3-4 years of related experience (provider relations, network management, provider customer service, sales-negotiation); prior negotiation experience; or any combination of education and experience, which would provide an equivalent background.

  • Excellent written and verbal communication skills required.

  • Medicaid experience preferred.

  • 50% local travel in East TN required.

  • An Equal Opportunity Employer/Disability/Veteran

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 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.