Anthem Network Relations Specialist - NE Rural Service Area of TX Required - PS6839 in Johnson City, Texas

Network Relations Specialist - NE Rural Service Area of TX Required - PS6839


Location: Texas, United States

Field: Provider Network Management

Requisition #: PS6839

Post Date: 4 days ago

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 .

This is an exceptional opportunity to do innovative work that means more to you and those we serve.

Develops and maintains positive relations with physicians, providers and practice managers within a local health plan's provider delivery system. Researches and resolves operational issues.

Primary duties may include, but are not limited to:

  • Works with MBUs operational departments to address provider grievances and service issues.

  • Provides explanations to providers regarding contract compliance, company procedures and policies, etc.

  • Recruits, orients and provides high quality service to providers.

  • Participates in the identification of sufficient number and location of providers to meet area needs.

  • Assists Contract Management group during contract negotiation by conducting some analysis and obtaining information.

  • Develops and enhances training programs for providers.

  • Conducts provider seminars and presentations on company networks, business operations, procedures and protocols.

  • Functions as a high level technical resource to resolve or facilitate complex provider issues.

  • Develops new provider programs and addresses major issues related to systems, customer service issues, new network implementation, etc. Instructs, trains, directs and checks the work of others.

  • Requires a BA/BS degree; 3-5 years experience as Network Services Specialist or as a Trainer; or any combination of education and experience, which would provide an equivalent background.

  • Provider Services experience strongly preferred.

  • Proficiency with Microsoft Product (Word, Outlook, Excel, PowerPoint).

  • Managed Care Experience preferred.

  • Medicare and Medicaid experience preferred.

  • Travel time may be required.

  • EOE.M/F/Disability/Veteran

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at at . EOE. M/F/Disability/Veteran.