Provider Network Manager Sr - Ps34130

Anthem, Inc. Portland , ME 04101

Posted 2 months ago

Your Talent. Our Vision. At Anthem Blue Cross and Blue Shield, a proud member of the Anthem, Inc. family of companies, 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.

Provider Network Mgr. Sr. - In the Office of South Portland, ME

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. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, 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. Primary duties may include, but are not limited to:

  • Serves as key resource for other contracting staff and provider relations staff.

  • 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 providers and the company.

  • Ensure that network composition includes an appropriate distribution of provider specialties.

  • Conducts complex negotiations and drafts documents.

  • Prepare financial projections and conduct analysis.

  • Requires a BA/BS degree; 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 various types of provider reimbursement models.

  • Strong oral and written communication required.

  • Strong negotiation skills required.

  • Analytical skills required.

  • Relationship building skills required.

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.


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