🌎
This job posting isn't available in all website languages

Settings

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

📁
Provider Network Management
📅
PS13935 Requisition #
Apply for Job
Share this Job
Sign Up for Job Alerts

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.

My Profile

Create and manage profiles for future opportunities.

Go to Profile

My Submissions

Track your opportunities.

My Submissions

Similar Listings

Cerritos, California, United States

📁 Provider Network Management

Requisition #: PS16602

Career Areas

At Anthem, Inc., there are many ways to make a difference. Here, the skills and passions of thousands come together, creating an impressive force with the power to change lives and the future of health care.

 

Actuarial

Contribute to analysis that impacts the financial future and well-being of our stakeholders, customers and the health care industry.

Read More

Find a Career

Administrative and
 Business Support

Use your exceptional organizational and interpersonal skills to help ensure the consistent, quality-driven performance of a consumer-centric industry leader.

Read More

Administrative Careers

Business Support Careers

 
 

Business Development and Sales

Be the embodiment of our "Easy-to-do Business With" Value, by treating our customers the way you would want to be treated and providing simple solutions that are easy to understand.

Read More

Business Development Careers

Sales Careers

Communications and Marketing

Lead the development of new messaging, products and innovations that continuously improve the value of our offerings to customers.

Read More

Communications Careers

Marketing Careers

 
 

Customer Care

Become the ultimate customer advocate. Share your expertise and help customers maximize the value of the tools and resources we provide.

Read More

Find a Career

Digital Transformation and Enablement

If you are eager to develop innovative digital products in healthcare and make a difference in people's lives, join our Digital organization and help us change the face of healthcare together.

Read More

Digital Solutions Careers

Digital Technologies Careers

 
 

Finance

Bolster the strategic objectives of a Fortune 50 industry leader, while supporting the tenet of financial integrity that is fundamental to Anthem, Inc.'s Purpose, Vision and Values.

Read More

Find a Career

Health Care Analytics

Provide strategic analysis that impacts business decisions, improves efficiency and drives innovation.

Read More

Find a Career

 
 

Human Resources

Lead our workforce and workplace talent strategies, to accomplish our vision to be recognized as America’s valued health partner.

Read More

Find a Career

Information Technology

Lead our workforce and workplace talent strategies, to accomplish our vision to be recognized as America's valued health partner.

Read More

Find a Career

 
 

Metrics & Data

Leverage your talents to make a difference in people's lives, by providing innovative, data-driven solutions that can measure and track progress in our members' health.

Read More

Find a Career

Medical

Drive the future of health care, by helping us improve health outcomes and quality of life for our associates, members and communities.

Read More

Find a Career

Underwriting

Work in areas of specialty as varied as Life & Disability Underwriting, Pre-Sales, Retention and Implementation, Risk Analysis and Medical Evidence Underwriting.

Read More

Find a Career

Operations

Stretch your analytic problem-solving skills while working on enterprise-level projects and cross-functional teams.

Read More

Find a Career

View All Jobs

Temporary Contract Opportunities

Associate
 Benefits

At Anthem, we’re in the business of taking care of people. In fact, everything we do is aimed at creating positive outcomes that make a difference in peoples’ lives, which of course includes our family of associates.

Learn More

Student Programs

Anthem continues to demonstrate the kind of visionary leadership needed to drive the future of health care. Our efforts and accomplishments have been recognized by numerous leading publications and organizations.

Learn More

Military and
 Veteran Careers

As one of America’s largest health benefits companies, we have a profound appreciation for service. Our organization proudly supports our nation’s active, reserve and veteran military service members and their spouses.

Learn More

Why Choose Anthem

Why is Anthem a respected industry leader? Our standards are high – for the service we provide our members and the support we show our associates. Every day, we answer the call – to do the right thing and to treat others with respect. This is the sense of purpose that leads Anthem to thrive, and which will ensure our future success, and yours.

 

Life at Anthem

How often do you get the chance to do something truly life-changing? If you work with us the answer is ... every day. Our determination to drive the future of health care is ambitious, but so are our people.

Learn More

Diversity & Inclusion

Diversity and inclusion play a major role in our success, because it’s more than just a philosophy to us, it drives our power to innovate. From our corporate culture and strategic partnerships, to our commitment to our associates, our customers and communities, diversity is foundational in everything we do.

Learn More