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Network Management Consultant - Los Angeles/Orange County/San Bernardino - #PS13935

Provider Network Management
PS13935 Requisition #
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Your Talent. Our Vision.  At CareMore, a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, it’s a powerful combination.  It’s 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.  CareMore Health  was founded by physicians 25 years ago. Over time, the company has evolved into a delivery system and health plan focused on innovating on the way our patients interact with the healthcare system. Today, CareMore operates in eight states and delivers care to over 100,000 patients through both the Medicare Advantage and Medicaid programs. The company is widely regarded as being on the leading edge of care delivery innovation.


To learn more about CareMore as an organization, you should read the following articles:

·       Des Moines Register – New Model: Insurers Hire Doctors

·       The Atlantic – The Quiet Healthcare Revolution


Location:  Los Angeles, Orange County, San Bernardino



The Network Management Consultant serves as CareMore’s face to our contracted Independent physician partners and works directly with the Provider Network Manager and Regional team of the market to improve provider performance and grow CareMore’s footprint. In this role, you would develop and maintain positive relationships with physicians, providers, and practice managers within the provider network. You would develop providers in the network through provider engagement initiatives for quality performance, grow the network through recruitment and simple contract negotiations, and general servicing of provider needs. This position serves as a communication link between providers and the CareMore. This is an independent role, operating with general supervision, expected to elevate unusual situations to management as required. In addition to day-to-day responsibilities, you would also be asked to participate in intradepartmental meetings required. Primary duties may include, but are not limited to:

  • Frequent and consistent visits to office out in the field-value proposition, organizing meetings, organizing PCP dinners, Portal usage/training,  onboarding of new providers, training to our model of care, secure completion of PAHAFs and HEDIS elements, train on corporate initiatives
  • Subject matter expert for neighborhood related network Issues: such as claims, authorizations, escalation for grievances and appeals, payment discrepancies, etc. Assist with member/provider issues, answer general network questions, address/educate and/or redirect member/provider related questions and requests for assistance from multiple departments
  • Working with sales to identify opportunities for growth, drive referrals from PCPs, assist with physician events, assist with marketing materials for physician events 

Requires a BA/BS degree; 2 years’ experience in 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 of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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