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Anthem, Inc Manager, Network Services - Tampa, Florida - PS27060 in Tampa, Florida

Manager, Network Services - Tampa, Florida - PS27060

Location: Tampa, Florida, United States


Requisition #: PS27060

Post Date: 6 days ago

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 drivethe 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.

Location: Tampa, Florida (5600 Mariner Street)

The Manager, Network Services is responsible for providing day-to-day direction for the operational team.

Primary duties include, but are not limited to:

  • Develops performance expectations and staffing projections for the assigned team.

  • Ad hoc production data requests to support/assist the assigned department.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

  • Develops and enhance Provider Relations department policies and procedures to ensure compliance with CMS and NCQA guidelines.

  • Monitors CMS HPMS memos, and analyzes impact on department processes.

Manages CMS CTM process, assisting in coordination of plan response to CTM complaints.

  • Develops and enhance Provider Relations department submissions to NCQA to maintain Plan accreditation.

  • Monitors area performance against service levels, reports status, proactively addresses issues and develops reduction/quality action plans as necessary.

  • Requires a BA/BS degree; 0-3 years’ experience leading/directing work of others; or any combination of education and experience, which would provide an equivalent background

  • Experience in the direct management of employees including developing and/or managing to performance expectations and quality metrics.

  • Experience in analytical reporting of production required.

  • Familiarity with insurance, healthcare, managed care industries preferred.

  • Experience with Facets or a comparable managed care or provider data maintenance system preferred

  • 5-7 years provider data and project management experience preferred.

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 An Equal Opportunity Employer/Disability/Veteran