Vacancy expired!
Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem Blue Cross and Blue Shield, 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
Management DirectorDevelops the
provider network through contract negotiations, relationship development, and
servicing for large health systems and affiliated physician groups including
employed and hospital based and hospital owned ancillary providers. Primary
focus of this role is contracting and negotiating contract terms. Deals with
only the most complex health systems, affiliated providers and drives and
support value base initiatives. Primary duties may include, but are not limited
to:
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.
Typically serves 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.
May assist management in network development planning.
May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
Contracts involve non-standard arrangements that require a high level of negotiation skills.
Fee schedules are customized.
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.
May collaborate with sales team in making presentations to employer groups.
Serves as a communication link between providers and the company.
Conducts the most complex negotiations.
Prepares financial projections and conducts analysis.
This position
must work from the Anthem Denver, CO office. Qualifications
Requires a BA/BS degree; 8 years’ experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Experience using financial models and analysis to negotiate rates with providers.
Strong organizational, problem solving and teamwork skills required. Aptitude for detail-oriented work.
Knowledge of Medicare is a plus.
Experience with WGS, Facets, EPDS and Contraxx is highly desired.
May require travel up to 10%.
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
Employer/Disability/Veteran.REQNUMBER: PS37176
Vacancy expired!