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Job Summary

Company
Anthem
Location
Little Rock, AR
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS4087

Dir Network Relations

About the 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.




Join the leadership team of Summit Community Care, a newly launched health plan and alliance between one of the fastest growing businesses at Anthem and the leading behavioral health provider coalition in Arkansas. Summit Community Care is poised to become the leading Medicaid health plan in Arkansas, under an innovative new behavioral health program designed by a forward-thinking state. This position affords the opportunity for the right candidate to build and grow a business from the ground up, while serving some the neediest Arkansans. At Summit Community Care, we do well by doing good.


Primary duties:


Directs the communication and complaint resolution strategies between physicians, hospitals, members, and the public.

Leads a team responsible for responding to inquiries from providers to clarify issues and performing education and training activities for provider offices to maintain constructive and effective relationships.

Understands the financial impacts of complex facility, provider and ancillary agreements and creates strategic plans to leverage relationships.

Analyzes provider network for adequacy in addressing members' medical needs and assists in the identification and recruitment of key providers where network gaps or needs exist. Leads all local efforts as it related to value based contracting.

Collaborates with local and corporate staff as necessary to ensure that appropriate contracts are executed and implemented and that all providers are credentialed in a timely manner.

Establishes and maintains positive and productive relationships in the provider community.

Responsible for budget accountability.

Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

Requires a BA/BS degree in business or related health field; 7-9 years experience; or any combination of education and experience, which would provide an equivalent background. Required hospital, physician and ancillary contracting experience. Knowledge of provider reimbursement methodologies, claims processing and billing practices preferred.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 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.


 

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