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Network Relations Consultant-Office Based (Houston or Dallas, TX) PS26991Location: Texas, United StatesNewRequisition #: PS26991Your 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 healthcare .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.A Network Relations Consultant develops and maintains positive relationships with providers
and develops strategies for recruitment and contracting.Primary duties may include, but are not limited to:
Develops and maintains positive relationshipswith the provider community by periodic on-site visits, communicatingadministrative or programmatic changes and facilitating the resolution ofprovider issues.
Recruits providers to build a cost effective, highquality provider network.
Conducts negotiations and leads contractingefforts with providers to build and maintain a cost effective, accessibleprovider network.
Researches, analyzes and recommends resolutionfor contract dispute, non-routine claim issues, billing questions and otherpractices.
Coordinates communication process on such issuesas administrative and medical policy, reimbursement and provider utilizationpatterns.
Conducts seminars to support the understandingof managed care and Blue Cross and Blue Shield policies and procedures.
Identifies network access and deficiencies anddevelops recruitment and contracting strategies.
Coordinates and conducts provider training.
Requires a Bachelor's degree; 3 years of provider network experience including 2 years experience as a Network Management Rep; or any combination of education and experience, which would provide an equivalent background.
Travel may be required.
Anthem, Inc. is ranked as one of America’sMost Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityIncmagazine Top 50 Company for Diversity. To learn more about our company andapply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
