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Dir Regional Network Mgmt ( Denver CO, Albuquerque NM,San Fr

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Job Details
Job Order Number
JC138957717
Company Name
Anthem, Inc
Physical Address

Topeka, KS 66612
Job Description

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:

• Oversees
the development, maintenance and reconciliation of physiciannetwork,
including but not limited torisk contracts and capitated arrangements.

• Attracts,
develops and manages key contracting and servicing staff.

• Develops
innovative ways to maintain a cost effective network with adequate access and
positive working relationships with providers.

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

• Serves
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.

• May
serve 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.

• Assists
management in network development planning

• Provide
work direction and establish priorities for field staff and involved in
associate development and mentoring.

• Works
with the most complex providers such as institutional providers,IPA/PHO’s,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.

• 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.

• Serves
as a communication link between professional providers and the company.

• Prepares
financial projections and conducts analysis.

• Identifies
and resolves network access gaps or perceived gaps.

• Responsible
for provider network in assigned geography

• Must
have network GAP analysis experience.

• Must
have expert/master knowledge with Microsoft Word, Powerpoint, Outlook, Excel.

• Hires,
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.


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