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Provider Network Management
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PS16913 Requisition #
Thanks for your interest in the Provider Experience Consultant - PS 16913 position. Unfortunately this position has been closed but you can search our 987 open jobs by clicking here.
  • Requires a BA/BS degree in Business or related field;
  • 5+ years’ experience in a healthcare organization supporting operations, provider or claims including experience with delivery of business systems and/or process improvement; 3+ years of experience with at least one aspect of the provider experience (provider call center, pricing, provider demographics); or any combination of education and experience, which would provide an equivalent background. 
Desired skills and preferences: 
  • Knowledge of mixers that link the members’ product/benefits and the providers contracting agreement together for claim processing. 
  • A good understanding of Pricing Configuration processes and pricing set up as well as ability to validate claims for pricing accuracy. 
  • Act as a SME on behalf of the Pricing Configuration Management (PCM) organization and able to provide input into business requirements. 
  • Exceptional results for project task assignments meeting timeliness and providing solid insights as well as provide project lead responsibilities. 
  • Possess strong communication skills both verbally and written.  Comfortable with presenting clear/effective materials to Stakeholders.
  • Ability to validate that claims are pricing as intended utilizing standardized and customized test case scenarios. 
  • Identify defects in the test cases and work with Project Managers, System Integration Testing and User Acceptance Testing to gain clarification/correction, request corrected claims for retesting.  
  • Ability to complete according to expected Service Level Agreements and reporting of results.
  • Core hours 8AM – 5PM with some flexibility
 
We currently have one opening for this position which may be located in any Anthem site location or remote.  Remote may be available after six months of hire.  Incumbent must be within a reasonable commuting distance from a primary office location.
 
Preferred locations:  Mason OH or Richmond VA but will consider other locations.
 
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Lead the development of new messaging, products and innovations that continuously improve the value of our offerings to customers.

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