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Network Relations Consultant - Seven Hills, OH (Office-based) - PS12372 in Seven Hills, OH at Anthem, Inc.

Date Posted: 12/5/2018

Job Snapshot

Job Description

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.
Develops and maintains 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 Blue Cross and Blue Shield 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.
Excellent written and verbal communication skills required.
Payment Innovation contracting experience preferred.

An Equal Opportunity Employer/Disability/Veteran
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran.