Provider Network Manager (NC Medicaid Alliance Operations) - Cary/Raleigh, NC #Ps24733

Anthem, Inc. Raleigh , NC 27611

Posted 3 months ago

Your Talent. Our Vision. At Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. company, 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.

Provider Network Manager

Cary, NC (Raleigh/Durham, NC)

The Provider Network Manager will develop the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. This role typically works with less-complex to complex providers. Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required.

Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. Value based concepts understanding. Fee schedules can be customized.

Other responsibilities include:

  • Works with increased independence and requires increased use of judgment and discretion.

  • May work on cross-functional projects requiring collaboration with other key areas.

  • Serves as a communication link between professional providers and the company.

  • Conducts more complex negotiations and drafts documents.

  • Assists in preparing financial projections and conducting analysis as required.

Requires a BA/BS degree; 3 years' experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background. May require travel up to 30%.

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.


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Provider Network Manager (NC Medicaid Alliance Operations) - Cary/Raleigh, NC #Ps24733

Anthem, Inc.