Dir Regional Network Mgmt ( Denver CO, Albuquerque NM,San Fr
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Topeka, KS 66612
Dir Regional Network Mgmt ( Denver CO, Albuquerque NM,San Francisco, San Diego, Los Angeles, Seattle,WA or Portland OR)
Location: United States
Requisition #: PS19519
Post Date: May 17, 2019
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.
The position requires the candidate to be in either of these cities Denver,CO, Albuquerque NM,
San Francisco,CA, San Diego,CA, Los Angeles,CA, Seattle WA or Portland OR
Responsible for network
development, provider reimbursement and network maintenance for a regional
Health Services Area.
Primary duties may include, but
are not limited to:
the development, maintenance and reconciliation of physiciannetwork,
including but not limited torisk contracts and capitated arrangements.
develops and manages key contracting and servicing staff.
innovative ways to maintain a cost effective network with adequate access and
positive working relationships with providers.
in a leadership capacity, leading associate resources, special
projects/initiatives, or network planning.
as a subject matter expert for local contracting efforts or in highly
specialized components of the contracting process and serves as subject matter
expert for that area for a business unit.
serve as lead contractor for large scale, multi-faceted negotiations.
as business unit representative on enterprise initiatives around network
management and leads projects with significant impact.
management in network development planning
work direction and establish priorities for field staff and involved in
associate development and mentoring.
with the most complex providers such as institutional providers,IPA/PHO’s,large
medical groups and ancillary providers, and providers in areas with significant
involve non-standard arrangements that require a high level of negotiation
independently and requires high level of judgment and discretion.
work on projects impacting the business unit requiring collaboration with other
key areas or serve on enterprise projects around network management.
as a communication link between professional providers and the company.
financial projections and conducts analysis.
and resolves network access gaps or perceived gaps.
for provider network in assigned geography
have network GAP analysis experience.
have expert/master knowledge with Microsoft Word, Powerpoint, Outlook, Excel.
trains, coaches, counsels, and evaluates performance of direct reports.
Requires a BS/BA degree in business administration or related healthcare field; 8-10 years healthcare operations, finance, underwriting, actuary, network development and sales experience; or any combination of education and experience, which would provide an equivalent background.
• Masters preferred.
Anthem, Inc. is ranked as one of America’sMost Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityIncmagazine Top 50 Company for Diversity. To learn more about our company andapply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.