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Provider Network Mgr I, Bradenton, FL (PS21493FH) at Anthem, Inc.

Posted in Management 30+ days ago.

This job brought to you by eQuest

Type: Full-Time
Location: Bradenton, Florida





Job Description:

Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide.

Your Talent. Our Vision. At America’s First Choice , a proud member of the Anthem, Inc. family of companies, 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.

 

Remote position within 2 months of employment following training and evidence of ability to work independently.

The Provider Network Mgr I 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 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; 2 years experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.

  • Up to 75% travel within Florida may be required travel.         

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.