Anthem Network Management Consult - San Diego, CA - 131018 in San Diego, California

/ 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 benefits companies and a Fortune Top 50 Company.

Provides provider relations/network management support to individual and provider group organizations. Serves as technical resource and mentor to other consultants.

Primary duties may include, but are not limited to: * Develops and follows through with network recruitment and retention strategies to ensure the retention and maintenance of high quality contracted providers. * Leads contracting efforts with individual and provider group organizations to build and maintain a cost effective, accessible provider network. * Identifies, researches and analyzes economic and professional provider practice patterns to develop recommendations for improvements. * Consults with, educates and trains providers on Anthem processes and programs. * Supports seminars to ensure the understanding of managed care and BCBS policies and procedures. * Participates in network expansion efforts to recruit new behavioral health providers and groups. * Researches, analyzes and recommends resolution for contract and reimbursement disputes, non-routine claim issues, billing questions and other practices. * Requires a BA/BS degree; 3-5 years experience in provider network management, utilization management or other health care field; or any combination of education and experience, which would provide an equivalent background. * EOE.M/F/Disability/Veteran

  • Requires a BA/BS degree; 3-5 years experience in provider network management, utilization management or other health care field; or any combination of education and experience, which would provide an equivalent background.
  • Experience with provider relations and processing provider contracts strongly desired.
  • Proficiency with MS Outlook, MS Excel, MS Word, and Adobe strongly desired.
  • Excellent written and verbal communication skills required.
  • Must be able to work both independently and with a team.
  • EOE.M/F/Disability/Veteran

/ 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 Management Consult - San Diego, CA - 131018

Location: CA-San Diego

Requisition ID: 131018