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Anthem, Inc. Network Management Consultant in Colorado Springs, Colorado

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater 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.

Title: Network Management Consultant

(This is not an IT position)

Preferred Location: Colorado

Status: Full-time, Salary, Bonus Potential

The Network Mgmt Consultant provides provider relations/network management support to complex, high profile provider organizations.

Primary duties may include, but are not limited to:

  • 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.

  • Researches, analyzes and recommends resolution for contract and reimbursement disputes and other practice support.

  • Manage and prepare data for reporting as directed by leadership

  • 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 groups. (focus on Primary Care)

  • Serves as technical resource and mentor to other consultants.

Qualifications

  • BA/BS degree;

  • 3-5 years’ experience in provider network management, utilization management or other health care field

  • Any combination of education and experience, which would provide an equivalent background.

Highly successfully candidates should have following experience:

  • Working directly with and supporting Primary Care Practices

  • Exposure to value base payment structure

  • Managing all aspects of provider recruitment and contracting negotiations

  • Strong fluency in the full Microsoft suite, specifically Excel, PowerPoint, OneNote, and Teams, as well as, ability to learn new operational systems

  • Colorado Medicaid Experience

  • Experience preparing and delivering training and communications

Applicable to Colorado Applicants Only

Annual Salary Range*: $73,283-$87,940

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

  • The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. 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. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

    REQNUMBER: PS50711

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