Anthem Provider Network Mgr II/Sr - (Various Anthem East & Central Locations) - 131087 in Louisville, Kentucky

/Your Talent. Our Vision./ At Anthem, Inc.,it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we willdrive 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.

/Position level will be determined upon candidates' skills, experience and education./ // Manages enterprise ancillary contracting efforts, with a focus on Medicaid , that provide a competitive advantage and deliver competitive cost of care trends. Primary duties include, but are not limited to:

Provider Network Manager II
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 more complex providers at least 50% of the time. Complex providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required. Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. Fee schedules can be customized. Works with increased independence and requires increased use of judgment and discretion. 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. Essential duties may include, but are not limited to: Serves as a communication link between professional providers and the company. Conducts more complex negotiations and drafts documents. Assists in preparing financial projections and conducting analysis as required. Performs other duties as assigned.

Provider Network Mgr Sr.

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. May collaborate with sales team in making presentations to employer groups. Essential duties may include, but are not limited to: Serves as a communication link between providers and the company. Conducts more complex negotiations and drafts documents. May prepare financial projections and conduct analysis as required. Performs other duties as assigned.

*Provider Network Manager II *

  • Requires BA/BS, Masters degree preferred, and 3-5 years experience in contracting, provider relations with an emphasis on Medicaid operations, provider servicing or any combination of education and experience that would afford equivalent competencies.
  • Ancillary contracting experience preferred.
  • Must have strong oral and written communication skills, good analytical skills, and PC skills.
  • Experience in market and network analysis preferred.
  • Experience developing reimbursement and contracting strategies preferred. Requires travel.

Provider Network Mgr Sr.

  • Requires BA/BS and 5-7 years experience in contracting, provider relations with an emphasis on Medicaid operations, provider servicing or any combination of education and experience that would afford equivalent competencies.
  • Ancillary contracting experience preferred.
  • Experience should include prior contracting experience.
  • Must have exceptional oral and written communication skills, strong analytical skills, and PC skills.
  • Must demonstrate leadership skills.
  • Requires travel.

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Any East or Central location at this time (Richmond preferred).

Candidate can be OPW based on hiring manager's discretion./*

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/ Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2015 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. / / /

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Job Provider Network Management

Title: Provider Network Mgr II/Sr - (Various Anthem East & Central Locations) - 131087

Location: VA-Richmond

Other Locations: NH-Manchester, GA-Atlanta, ME-South Portland, NY-Melville, WI-Waukesha, MO-St. Louis, CT-Wallingford, NY-New York City, OH-Mason, KY-Louisville, IN-Indianapolis

Requisition ID: 131087