Anthem Provider Network Development Analyst Ld (Medicare West Region) - 130505 in Andover, Massachusetts

/ Your Talent. Our Vision. /* At Anthem, Inc., * 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. Join us and together we willdrive 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.

  • Provider Network Development Analyst Ld – 130505 *

    Location: Any West region states preferably TX, CA, UT

    Travel required. Travel to Utah will be frequent during the first year.

    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:

    Leads Network expansion activities/calls with Regional Network and Reporting team.

    • Serves as a communication link between professional providers and the company.

    • Conducts fee-for-service contracting, negotiating contract terms and drafts documents.

    • Assists in preparing financial projections as required.

    • Serves as the key data management, acquisition, and analysis resource.

    • Manages statewide provider development activities. Expansion and Existing MA States.

    • Manages the networks of assigned health care providers.

    • Develops strategies and plans for internal and external provider communications and development.

    • Implements the development strategies for professional provider networks.

    • Identifies network access deficiencies and recommends corrective actions.

    • Oversees the negotiation of favorable contracts to include fee for service and capitation.

    • Analyzes provider utilization data and recommends strategies to remove poor performers from the networks.

    Requires a BA/BS degree; • 8-9 years experience which must include provider experience in contracting , provider relations, provider servicing, and CMS network filing ( HSD’s Tables and Provider Exceptions); or any combination of education and relevant experience. • Experience with data analysis and data management. • Requires travel approximately 15% within West region of the US with some overnight stay. Willing and able to travel frequently to Utah during Network expansion. • Proficiency in MS Office products – must be intermediate/advanced in Excel • CMS filing experience. • Experience with SharePoint is strongly 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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Job Provider Network Management

Title: Provider Network Development Analyst Ld (Medicare West Region) - 130505

Location: MA-Andover

Other Locations: TX-Grand Prairie, TX-Corpus Christi, TX-Beaumont, CA-Lawndale, AZ-Mesa, CA-Pico Rivera, CA-Modesto, Colorado, CA-Riverside, CA-Woodland Hills, WA-Olympia, CA-Montebello, UT-Salt Lake City, TX-Midland, TX-San Angelo, Utah, CA-Santa Fe Springs, CA-Hacienda Heights, TX-Wichita Falls, CA-Placentia, CA-Gilroy, CA-Santa Ana, CA-San Jose, AZ-Scottsdale, CA-Corona, TX-Lubbock, TX-San Antonio, Texas, Nevada, WA-Seattle, TX-Denison, TX-Abilene, CA-Apple Valley, CA-Norwalk, WA-Tumwater, AZ-Tucson, CA-Cerritos, TX-Austin, TX-Fort Worth, New Mexico, CA-Torrance, CA-Downey, TX-Houston, CA-Whittier, TX-El Paso, CA-Beverly Hills, CA-West Covina, CA-La Mirada, CA-Victorville, CA-Visalia, NV-Las Vegas, CA-Turlock, Washington, NV-Reno, CA-Glendale, CO-Colorado Springs, CO-Denver, CA-Diamond Bar, CA-Costa Mesa, CA-Upland, CA-Alameda, CA-Hesperia, CA-Newbury Park, TX-Odessa, CA-La Habra, CA-Los Angeles, CA-Fresno, NV-Henderson, CA-Long Beach, CA-San Diego, CA-Patterson, CA-San Francisco, CA-Sacramento, CA-Pomona, CA-Rancho Cordova, TX-Dallas, CA-North Hollywood, California, Arizona, CA-Walnut Creek, NM-Albuquerque, CA-Brea, CA-Thousand Oaks, CA-Santa Barbara

Requisition ID: 130505