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Provider Network Manager I- PS37589

Company: Anthem, Inc.
Location: Glendale
Posted on: September 12, 2020

Job Description:

Welcome to the Anthem Careers site! We have been hard at work to improve our job search and application systems to better serve you. It is now easier to find and apply for relevant jobs as well stay connected with Anthem. Here are a few of the updates you may notice:

No more profiles! We no longer require you to create a log in and password to apply for a job and you won't be able to access previously created profiles, but don’t worry – we still have your previous application(s) on file. Due to technical difficulties currently being resolved, the ‘Track Your Job Application Status’ functionality is not available.

Job Alerts – If you had previously registered to receive job alerts and wish to continue to receive these notifications, please re-register by clicking the “job alert” button.

NEW! Didn’t find a job that is right for you? Join a Talent Network to stay informed on news and job opportunities with the Anthem Team!

It is important that you apply using an email address which is unique to you and not shared with a friend, relative, spouse, or significant other. Our recruiting system uses your email address as your unique identifier. If you apply with a shared email address, your application will overwrite any previous applicant record with the same email address. Additionally, please ensure that you use a valid email address, free from typos, as there are a variety of communications which may be sent to the email address with which you apply

Your Talent. Our Vision. At Anthem Blue Cross , 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 Manager I

This position is responsible for developing and expanding on relationships with Anthem Blue Cross physician, physician groups, IPAs/Primary Medical Groups (PMGs), Contracted facilities, hospital and ancillary networks and managing the functions relating to provider servicing, operations, provider education, and network development within Southern California.

Primary duties may include, but are not limited to:

Project Management of local and statewide tasks associated with Network Relations, such as tracking and trending of processes, monitoring complex and resource intensive projects, and delivery of updates to both to Leadership and Network Relations staff.

Analysis and evaluation of current provider, specialty and ancillary networks.Identify gaps and deficiencies, and provide results with opportunities.

Supports Network Relations staff with urgent and pressing disputes coming from the Anthem network.Involvement in claims, member, and clinical related research and engagement for escalation.

Responsible for the monitoring of Quality of Service to our network clients, surveying the Anthem provider network based on Delegated models with PMGs, and operational distinctions between the Health Plan and a PMG.

Assist in development of advocacy and education processes and communications with providers, PMGs, hospitals and ancillary networks. Including informational bulletins, power point presentations, and other materials required for external or internal communications. - In conjunction with leadership, assist in the development of strategies for growth and branding throughout the provider network.

Develops and implements a tracking processes that ensure providers, PMGs, hospitals and ancillary provider complaints and issues are mitigated in a reasonable time period.

Engagement and support escalated issues coming from State and Local oversight agencies.

The position will work from the Glendale, CA office.

Currently, due to COVID-19, this position is remote/work from home. Working in the office will resume once it is deemed safe per the guidelines followed.

Qualifications

Requires a BA/BS in Business Administration, Healthcare Administration, or a related field; and 1-2 years of experience in a managed healthcare or hospital environment, 2+ years of experience in provider/network relations; 1-2 years of leadership/ management experience; or any combination of education and experience, which would provide an equivalent background.

Experience developing relationships with physicians/providers is required.

Experience with network relations, provider contracting, provider servicing and education is required.

Knowledge of State Medi-Cal Program.

Knowledge of network contracting models in California.

Knowledge of different reimbursement methodologies based on Medicaid and CMS guidelines is required.

Must have healthcare experience.

Must have excellent communication skills (written and verbal) and interpersonal skills.

Requires strong organizational and project management skills.

Valid driver's license and access to a motor vehicle required; 50% travel.

Anthem, Inc. is ranked as one of America’s Most AdmiredCompanies among health insurers by Fortune magazine and has been named a 2019Best Employers for Diversity by Forbes. To learn more about our company andapply, please visit us at careers.antheminc.com. AnEqual Opportunity Employer/Disability/Veteran.

Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.

EEO is the Law Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.

Anthem, Inc. is committed to helping individuals with disabilities participate in the workforce and ensuring equal opportunity to apply and compete for jobs. If you are an individual with a disability and require a reasonable accommodation to complete the application process, please email Human Resources at ability@icareerhelp.com for further assistance.

*WARNING : Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Please be advised that Anthem will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission here by selecting the ‘Rip-offs and Imposter Scams’ option. Anthem requires a completed online application for consideration of employment for any position.

Keywords: Anthem, Inc., Glendale , Provider Network Manager I- PS37589, Other , Glendale, Arizona

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