It is important that you apply using an email address which is
unique to you and not shared with a friend, relative, spouse, or
significant other. Our recruiting system uses your email address as
your unique identifier. If you apply with a shared email address,
your application will overwrite any previous applicant record with
the same email address. Additionally, please ensure that you use a
valid email address, free from typos, as there are a variety of
communications which may be sent to the email address with which
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 care companies and a Fortune Top 50 Company.
The Network Management Consultant Senior serves as technical
resource, trainer and mentor to other consultants and contracting
staff members. Provides provider relations and/or network
management consulting support to complex, and/or large high profile
Primary duties may include, but are not limited to:
Provides guidance regarding resolution of issues that require
the intervention of the Provider Engagement and Contracting
Identifies and facilitates process improvement projects to
improve network provider’s experience, to reduce provider abrasion
and to reduce costs.
Serves on inter-departmental committees and project teams to
assist with root cause analysis of provider issues, and
communicates positive outcomes/solutions to provider
Develops and maintains policies and procedures and provides
training to team members.
Acts as department lead in manager’s absence.
Develops and maintains positive relationships with the provider
community with primary focus on Social Determinants of Health, such
as food and housing insecurities; conducting routine and
issue-based on-site visits, communicating administrative or
programmatic changes and facilitating the resolution of provider
Researches, analyzes and recommends resolution for contract and
reimbursement disputes, non-routine claim issues, billing questions
and other practices.
Conducts seminars to support the understanding of managed care
and BCBS policies and procedures.
Assists with network recruitment and retention strategies to
ensure the retention and maintenance of high quality contracted
Participates in large and/or complex network expansion efforts
to recruit new physician specialties or large physician groups.
Requires a BA/BS degree in business, health administration or
related field; 5-7 years of experience in provider network
management, utilization management or related health care field; or
any combination of education and experience, which would provide an
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
Please be advised that Anthem only accepts resumes from agencies
that have a signed agreement with Anthem. Accordingly, Anthem is
not obligated to pay referral fees to any agency that is not a
party to an agreement with Anthem. Thus, any unsolicited resumes,
including those submitted to hiring managers, are deemed to be the
property of Anthem.
EEO is the Law Please use the links below to review statements
of protection from discrimination under Federal law for job
applicants and employees.
Anthem, Inc. is committed to helping individuals with
disabilities participate in the workforce and ensuring equal
opportunity to apply and compete for jobs. If you are an individual
with a disability and require a reasonable accommodation to
complete the application process, please email Human Resources at
firstname.lastname@example.org for further assistance.
*WARNING : Please beware of phishing scams that solicit
interviews or promote work-at-home opportunities, some of which may
pose as legitimate companies. Please be advised that Anthem will
never ask you for a credit card, send you a check, or ask you for
any type of payment as part of consideration for employment with
our company. If you feel that you have been the victim of a scam
such as this, please report the incident to the Federal Trade
Commission here by selecting the ‘Rip-offs and Imposter Scams’
option. Anthem requires a completed online application for
consideration of employment for any position.