Provider Network Manager Sr

16 Jun 2024

Vacancy expired!

Description SHIFT: Day JobSCHEDULE: Full-timePosition: Provider Network Manager Sr Location: Atlanta, GA (70% Remote, 30% Travel) 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? How will you make an impact: Develops and supports value-based contracting across all lines of business with a particular focus on the Medicare and Medicaid lines of business. Responsible for contract negotiations provider’s program performance, relationship development, and servicing. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups, and clinically integrated networks (CIN). Contracts involve non-standard arrangements that require a high level of fee for service and value based contracting negotiation skills. Fee schedules are frequently negotiated and customized. Primary duties may include, but are not limited to: Serves as a key resource, on value based contracting concepts for other contracting staff. Works independently and requires a 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 providers and employer groups. Serves as a communication link between professional providers and the company. Ensure that Medicare network composition includes an appropriate distribution of provider specialties, and meets CMS, and sales, access requirements. Prepares contract documents, ensures contracts are compliant with market and Enterprise PADU contracting guidelines, and ensures contracts are successfully executed and loaded. Prepare financial projections and conduct analysis. Qualifications Qualifications: Requires a BA/BS degree and a minimum of 5 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. Experience in fee schedule development using actuarial models strongly preferred. May require travel up to 30%. Preferred Qualification: Experience should include prior Medicare, Medicaid, and value-based contracting. 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: PS72376-Cartersville-Cartersville

Full-time
  • ID: #43142667
  • State: Georgia Cartersville 30120 Cartersville USA
  • City: Cartersville
  • Salary: USD TBD TBD
  • Showed: 2022-06-16
  • Deadline: 2022-08-16
  • Category: Et cetera