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Anthem, Inc. Provider Network Manager Sr in Brooklyn, New York

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

Title: Provider Network Manager Sr

Ideal Location: Connecticut (neighboring states will be considered )

Status: Full-time, Salary, Bonus Potential

The Provider Network Manager Sr 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 the most complex providers. Complex providers may include, but are not limited to large health systems 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 key resource for other contracting staff and provides mentoring and on-the-job training and development. Works independently and requires high level of judgment and discretion.

  • May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.

  • May collaborate with 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.

  • Oversight of value based care arrangements

  • Conducts more complex negotiations and drafts documents.

  • Prepare financial projections and conduct analysis.

Qualifications

  • BA/BS degree

  • 5 years’ experience in contracting, provider relations, provider servicing;

  • Experience should include prior contracting experience (Fee for service and value based arrangements)

  • Any combination of education and experience, which would provide an equivalent background.

  • Experience in fee schedule development using actuarial models.

  • May require travel up to 30%.

Successful candidates should have the following qualities:

  • Provider and/or Payer Experience

  • Contract negotiation skills

  • General Understanding of Value Based Care

  • Kindness, compassion, empathy and a profound desire to help people

  • Ability to build relationships and influence others

  • Proven demonstration of leadership and strategic capabilities

  • Adaptability and flexibility

  • Accountability and execution oriented

  • Analytical and problem solving skills

  • Creativity and critical thinking skills

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

REQNUMBER: PS51173-New%20York

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