/Your Talent. Our Vision./AtAnthem, Inc.,it's a powerful combination, and the foundation upon which we're creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we willdrive 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 benefits companies and a Fortune Top 50 Company.
TheNetwork Relations Consultantposition is responsible for developing and maintaining positive relationships with providers and develops strategies for recruitment and contracting.
Primary duties may include, but are not limited to:
- Develops and maintains positive relationships with the provider community by periodic on-site visits, communicating administrative or programmatic changes and facilitating the resolution of provider issues.
- Recruits providers to build a cost effective, high quality provider network.
- Conducts negotiations and leads contracting efforts with providers to build and maintain a cost effective, accessible provider network.
- Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.
- Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
- Conducts seminars to support the understanding of managed care and companies policies and procedures.
- Identifies network access and deficiencies and develops recruitment and contracting strategies.
- Coordinates and conducts provider training.
Requires a BA/BS degree; 3 years of related experience (provider relations, network management, customer service, sales-negotiation); prior negotiation experience; OR any combination of education and experience, which would provide an equivalent background.
Strong written, oral and interpersonal communication skills required.
Good analytical skills and strong PC skills required.
Negotiation skills preferred.
Excellent presentation skills required.
/Local travel required. /
/Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2016 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran./
Job Provider Network Management
Title: Network Relations Consultant (Atlanta, GA) - 122446
Requisition ID: 122446
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