Provider Contract Specialist Manager - Las Vegas - 89173

Company: anthem
Location: Las Vegas
Posted on: June 13, 2021

Job Description:

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PROVIDER CONTRACT SPECIALIST MANAGER

Location: Las Vegas, NV Job Family: Provider Network Management Req #: PS51017-Las%20Vegas-Las%20Vegas Date Posted: Jun 1, 2021

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were 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.

NOTE: This position is work from home, with the physical location of the applicant being within a reasonable commute to anyAnthem office in the US.

Responsibilities

Functions with the expertise in managing negotiated pricing loads. Responsible for coordinating the process for the most complex pricing arrangements involving facilities or large health systems, or high profile provider groups and/or physician groups tied to large hospital systems joining the network including creating standard contracts for providers as needed. Primary duties may include, but are not limited to:

* Manage provider update files submitted by delegated provider entities and/or large groups/integrated delivery system. * Prepare the information for timely and accurate submission to the Provider Data Management area. * Ensure updates/changes for existing network providers are interpreted and loaded accurately. * Ensure accurate and timely loading of professional and facility contracts across value based and fee for service agreements for provider solutions. * Works directly with contracting directors and managers to understand what is negotiated and how the negotiated agreement is translated into the company's systems resulting in accurate and timely loading. * Performs internal audit of provider record, ensuring accuracy against rosters. * Serves as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround. * Serve as local market expert supporting (and managing when necessary) the provider onboarding process and provider updates submitted by provider offices within defined market. * Must possess critical thinking skills, have a proven strong eye for detail and a focus on quality.

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.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For, is ranked as one of the 2020 Worlds Most Admired Companies among health insurers by Fortune magazine, and a 2020 Americas Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Qualifications

* Requires a H.S. diploma; at least 5 years of experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background.

The health and safety of Anthem associates and the various stakeholders we service is a top priority for our business every day. Anthems workplace of the future will be both physical and virtual with the number of sites optimized to promote access to diverse, top talent.

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.

Keywords: anthem, Las Vegas , Provider Contract Specialist Manager - Las Vegas - 89173, Other , Las Vegas, Nevada