Anthem Provider Network Mgt Dir in Lubbock, Texas
Provider Network Mgt Dir
Location: United States
Field: Provider Network Management
Requisition #: 139966
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 Mgt. Director
Preferred Work Location - Eastern or Central time zone of the US
Develops the provider network through contract negotiations, relationship development, and servicing for large health systems and includes multiple provider types, ancillary, hospitals and physicians (not just one of these provider types). Primary focus of this role is contracting and negotiating contract terms. Spends a minimum of 50% of the time either in a leadership role or that of subject matter expert and deals with only the most complex providers.
Primary duties may include, but are not limited to:
· Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
· Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit.
· Typically serves as lead contractor for large scale, multi-faceted negotiations.
· Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.
· May assist management in network development planning.
· May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
· Works with the most complex providers such as institutional providers, large medical groups and ancillary providers, and providers in areas with significant competition.
· Contracts involve non-standard arrangements that require a high level of negotiation skills.
· Works independently and requires high level of judgment and discretion.
· May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
· Serves as a communication link between professional providers and the company.
· Conducts the most complex negotiations.
· Prepares financial projections and conducts analysis.
· Identifies and resolves network access gaps or perceived gaps.
· May be responsible for specific provider types and/or geographies.
· Must have Network Adequacy and GAP analysis reporting experience.
· Must have expert/master knowledge with Microsoft Word, Powerpoint, Outlook, Excel.
Requires a BA/BS degree; 8-10 years experience in contracting, provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Federal program provider contracting experience is preferred.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 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.