Anthem, Inc. Provider Network Mgr I in Hingham, Massachusetts
SHIFT: Day Job
Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, 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.
For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Location: Position can be remote. Must reside in New England territory
(Maine, Vermont, New Hampshire, Massachusetts, Rhode Island, or Connecticut)
The Provider Network Mgr. 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 providers which may include, but are not limited to, professional providers, practice groups, small medical groups, behavioral health facilities and providers with greater familiarity with managed care concepts.
Contracts tend to be more standard and afford less opportunity for customization.
Fee schedules are fairly standardized with reimbursement models limited and well-defined.
May participate in intradepartmental projects or smaller projects impacting multiple departments.
Operates with general supervision, elevating unusual situations to management as required.
Primary duties may include, but are not limited to:
Solicits participation in the network and conducts re-contracting efforts as needed.
Serves as a communication link between professional providers and the company.
Conducts negotiations and drafts documents.
Assists in preparing financial projections as required.
Requires a BA/BS degree; 2 years experience in contracting, provider relations, provider servicing; 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 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.