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Provider Network Manager Senior - CA - PS28657Location: California, United StatesNewRequisition #: PS28657Your 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.Provider Network Manager SeniorLocation: CA RemoteThe Provider Network Manager Senior 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 the most complex providers at least 50% of the time. Complex providers may include, but are not limited to institutional providers, large medical groups and 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. Primary duties may include, but are not limited to:
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 projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
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.
May prepare financial projections and conduct analysis.
Requires a BA/BS degree; 5-7 years experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
CA managed care provider market strongly preferred.
Capitated medical negotiations and hospital negotiations strongly preferred.
Real-time negotiation and contracting experience required.
Strong written and verbal communications skills.
Must live in California.
Requires 20% statewide travel.
Strong analytic skills preferred.
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.
