Anthem Provider Network Manager (CareMore) - Richmond, VA in San Diego, California
/ Your Talent. Our Vision. / At CareMore , a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, 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.
CareMore’s Provider Network Manager 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. Typically works with less complex providers which may include, but are not limited to, professional providers, practice groups, small medical groups, providers in less competitive markets, 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 limited negotiations and drafts documents.
· Assists in preparing financial projections as required.
Requires a BA/BS degree; two (2) years of experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.
Travel required./ Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2015 Diversity, Inc. 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./
Job Provider Network Management
Title: Provider Network Manager (CareMore) - Richmond, VA
Location: california-San Diego
Other Locations: VA-Richmond
Requisition ID: 130631