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Anthem, Inc. Provider Network Management Director (PS34545) in Washington DC, District Of Columbia

Provider Network Management Director (PS34545)

Location: Ohio, United States

New

Requisition #: PS34545

Post Date: 3 days ago

Your 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 health care .

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.

This opportunity is open to working from one of our Anthem facilities, or working from home; Eastern or Central time zones are preferred; however all states nationwide are opportunities for consideration.

The Provider Network Management Director develops the provider network through contract negotiations, relationship development, and servicing for large health systems and includes multiple provider types, ancillary, hospitals and physicians (not just one of these provider types). Primary focus of this role is contracting and negotiating contract terms. Spends a minimum of 50% of the time either in a leadership role or that of subject matter expert and deals with only the most complex providers.

Primary duties may include, but are not limited to:

  • Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.

  • Serves as a subject matter expert for enterprise contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit.

  • Typically serves as lead contractor for large scale, multi-faceted negotiations.

  • Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.

  • May assist management in network development planning.

  • May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.

  • Works with the most complex providers such as institutional providers, large medical groups and ancillary providers, and providers in areas with significant competition.

  • Contracts involve non-standard arrangements that require a high level of negotiation skills.

  • Fee schedules or reimbursement methodologies are typically customized.

  • 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 professional providers and the company.

  • Conducts the most complex negotiations.

  • Prepares financial projections and conducts analysis.

  • Requires a BA/BS degree; 8-10 years experience in contracting, provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.

  • MBA preferred.

  • Previous experience with Transplant Contracting is highly preferred.

  • Proficiency with Excel, Word, and PowerPoint is essential.

  • Strong negotiation skills, analytical skills, and knowledge of contract language.

  • May require some travel.

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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