Provider Network Manager – Medicaid / Medicare


Description: Description SHIFT: Day Job SCHEDULE: Full-time Be part of an extraordinary team! We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact? Provider Network Manager – Medicaid / Medicare (PS70008) Location: Remote. Must reside in Louisiana. Prefer commutable distance to New Orleans or Baton Rouge.

How you will make an impact: The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary focus of this role is: * Provider contracting and negotiating contract terms. * Typically works with less-complex to complex providers. * Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required. * Contracts may involve non-standard arrangements that require a moderate level of negotiation skills.

Value based concepts understanding. Fee schedules can be customized. * Works with increased independence and requires increased use of judgment and discretion. * May work on cross-functional projects requiring collaboration with other key areas. * Serves as a communication link between professional providers and the company.

* Conducts more complex negotiations and drafts documents. * Assists in preparing financial projections and conducting analysis as required. Qualifications Minimum Requirements: * BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background. * Requires some travel within the state of Louisiana. Preferred Qualifications: * Managed Care/health insurance industry experience.

* Knowledge of Medicaid and Medicare provider contracting preferred. * Experience negotiating provider contracts. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19.

If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.

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