Anthem Provider Network Mgr II in Lubbock, Texas
Provider Network Mgr II
Location: United States
Field: Provider Network Management
Requisition #: 139969
Post Date: Mar 06, 2018
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 benefits companies and a Fortune Top 50 Company.
The Provider Network Mgr II
Preferred Work Location - Eastern or Central Time Zone in the US
Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. 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. Works with increased independence and requires increased use of judgment and discretion.
Primary duties may include, but are not limited to:
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.
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.
Identifies and resolves network access gaps or perceived gaps.
May be responsible for specific provider types and/or geographies.
Requires a BA/BS degree; 3-5 years experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.
Federal program provider contracting experience preferred.