Description
SHIFT: Day Job
SCHEDULE: Full-time
Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Location: 100% Remote
Primary duties may include, but are not limited to:
Provides provider relations/network management consulting support to complex, high profile provider organizations.
Serves as technical resource and mentor to other consultants.
Develops network recruitment and retention strategies to ensure the retention and maintenance of high quality contracted providers.
Conducts negotiations and leads contracting efforts with complex, high profile provider organizations to build and maintain a cost effective, accessible provider network.
Identifies, researches and analyzes economic and professional provider practice patterns to develop recommendations for improvements.
Consults with, educates and trains providers on innovative alternative reimbursement programs.
Conducts seminars to support the understanding of managed care and BCBS policies and procedures.
Participates in network expansion efforts to recruit new physician specialties or large physician groups.
Researches, analyzes and recommends resolution for contract and reimbursement disputes, non-routine claim issues, billing questions and other practices.
Qualifications
Minimum Requirements
Requires a BA/BS degree and a minimum of 3 years experience in provider network management, utilization management or other health care field; or any combination of education and experience, which would provide an equivalent background.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.
REQNUMBER: PS71663-US
