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Provider Network Mgr I/II - Miami, FL (PS2764) in Miami, FL at Anthem, Inc.

Date Posted: 3/14/2018

Job Snapshot

  • Employee Type:
  • Location:
    Miami, FL
  • Job Type:
  • Experience:
    At least 2 year(s)
  • Date Posted:

Job Description

Your Talent.  Our Vision.  At Simply Healthcare, a proud member of the Anthem, Inc. family of companies, 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. We are a Florida licensed health maintenance organization that serves individuals enrolled in Medicaid and/or Medicare programs, 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.  

Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with less complex providers which may include, but are not limited to, professional providers, practice groups, small medical groups, providers in less competitive markets, and providers with greater familiarity with managed care concepts. Contracts tend to be more standard and afford less opportunity for customization. Fee schedules are fairly standardized with reimbursement models limited and well-defined. May participate in intradepartmental projects or smaller projects impacting multiple departments. Operates with general supervision, elevating unusual situations to management as required.

Primary duties may include, but are not limited to:
  • Solicits participation in the network and conducts re-contracting efforts as needed.
  • Serves as a communication link between professional providers and the company.
  • Conducts limited negotiations and drafts documents.
  • Assists in preparing financial projections as required. 

Job Requirements

Requires a BA/BS degree; 2 years experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background. Requires travel.

Anthem, Inc. is ranked as one ofAmerica’s Most Admired Companies among health insurers by Fortune magazine andis a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn moreabout our company and apply, please visit us at EOE.M/F/Disability/Veteran.