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Anthem, Inc. Provider Network Manager I, II, or Sr. - PS37528 in Cary, North Carolina

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 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.

Provider Network Manager I, II, or Sr. - Must be located in an Anthem office

(Level of hire will determined by the hiring manager)

The Provider Network Manager I, II, or Sr. will develop the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. The Manager II or Sr. role will typically work with the most complex providers at least 50% of the time. Complex providers may include, but are not limited to institutional providers, large medical groups and ancillary providers, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve nonstandard arrangements that require a high level of negotiation skills. Fee schedules are often customized. Primary duties may include, but are not limited to:

Provider Network Manager I:

  • 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 needed.

Provider Network Manager II:

  • Serves as resource for lower leveled consultants.

  • May work on cross-functional projects requiring collaboration with other key areas.

  • May collaborate with sales team in making presentations to employer groups.

Provider Network Manager Sr.:

  • Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.

  • May serve as lead over a contracting team engaged in less complex negotiations.

  • 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.

  • Conducts more complex negotiations and drafts documents.

  • May prepare financial projections and conduct analysis.

Qualifications

Provider Network Manager I:

  • BA/BS degree

  • 2 years of experience in contracting, provider relations, provider servicing or any combination of education and experience which would provide an equivalent background.

  • Requires some travel.

Provider Network Manager II:

  • BA/BS degree

  • 3-5 years of experience in contracting, provider relations, provider servicing or any combination of education and experience which would provide an equivalent background.

  • Requires some travel

Provider Network Manager Sr.:

  • BA/BS degree

  • 5-7 years of experience in contracting, provider relations, provider servicing or any combination of education and experience which would provide an equivalent background.

  • Requires some travel.

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: PS37528-US

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