Anthem, Inc. Provider Network Mgr Sr (PS37588) in West Covina, California
SHIFT: Day Job
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 care companies and a Fortune Top 50 Company.
This is a remote opportunity, Northern California region preferred.
The Provider Network Mgr Sr. is responsible for developing the provider network through contract negotiations, relationship development, and servicing.
Primary focus of this role is contracting and negotiating contract terms. This level typically works with the most complex providers at least 50% of the time. Complex providers may include, but are not limited to institutional providers, professional providers with complex contracts, medical groups, ancillary providers, 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 often customized.
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 cross-functional projects requiring collaboration with other key areas or serve on enterprise projects around network management as needed.
Essential duties may include, but are not limited to:
Serves as an external communication link between providers and the company.
Serves as an internal stakeholder, and is responsible for the inter-department tasks associated with this role.
Conducts more complex negotiations and drafts documents.
May prepare financial projections and conduct analysis as required.
Will develop and manage workflows associated with the responsibilities of this role.
Performs other duties as assigned.
Provider Network Mgr Sr.
Requires BA/BS and 5-7 years experience in contracting, provider relations with an emphasis on Commercial operations, provider servicing or any combination of education and experience that would afford equivalent competencies.
Facility, Ancillary, IPA/PHO and large physician group contracting experience preferred.
Must have exceptional oral and written communication skills, strong analytical skills, and PC skills.
Must demonstrate leadership skills, ability to work independently and be self-motivated.
Project management experience strongly preferred.
Occasional local travel may be required.
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.