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 care companies and a Fortune Top 50 Company.
The Network Management Consultant Senior serves as technical
resource, trainer and mentor to other consultants and contracting
staff members. Provides provider relations and/or network
management consulting support to complex, and/or large high profile
Primary duties may include, but are not limited to:
Provides guidance regarding resolution of issues that require
the intervention of the Provider Engagement and Contracting
Identifies and facilitates process improvement projects to
improve network provider’s experience, to reduce provider abrasion
and to reduce costs.
Serves on inter-departmental committees and project teams to
assist with root cause analysis of provider issues, and
communicates positive outcomes/solutions to provider
Develops and maintains policies and procedures and provides
training to team members.
Acts as department lead in manager’s absence.
Develops and maintains positive relationships with the provider
community with primary focus on Social Determinants of Health, such
as food and housing insecurities; conducting routine and
issue-based on-site visits, communicating administrative or
programmatic changes and facilitating the resolution of provider
Researches, analyzes and recommends resolution for contract and
reimbursement disputes, non-routine claim issues, billing questions
and other practices.
Conducts seminars to support the understanding of managed care
and BCBS policies and procedures.
Assists with network recruitment and retention strategies to
ensure the retention and maintenance of high quality contracted
Participates in large and/or complex network expansion efforts
to recruit new physician specialties or large physician groups.
Requires a BA/BS degree in business, health administration or
related field; 5-7 years of experience in provider network
management, utilization management or related health care field; or
any combination of education and experience, which would provide an
Anthem, Inc. is ranked as one of America’s Most Admired
Companies among health insurers by Fortune magazine and has been
named a 2019 Best Employers for Diversity by Forbes. To learn more
about our company and apply, please visit us at
careers.antheminc.com. An Equal Opportunity