Network Relations Consultant
Company: Anthem, Inc.
Posted on: February 24, 2021
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which is unique to you and not shared with a friend, relative,
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address, your application will overwrite any previous applicant
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that you use a valid email address, free from typos, as there are a
variety of communications which may be sent to the email address
with which you apply Network Relations Consultant Your Talent. Our
Vision. At Anthem, Inc., it's a powerful combination, and 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 at one of America's
leading health care companies and a Fortune Top 50 Company. Network
Relations Consultant Remote opportunity-North Carolina (Preferred
location - reside in one of the following cities- Asheville, Black
Mountain, Marion, Weaverville, Marshall, Waynesville, Sylva,
Glenville, Brevard, Hendersonville, Fletcher, Robbinsville, Topton,
Andrews, Murphy, Hayesville, Franklin, Highlands Lenoir, Morganton,
Bryson City), NC Possible other locations include ; Cary, NC,
Raleigh-Durham, NC The--Network Relations Consultant--will develop
and maintain positive relationships with the provider community by
regular on-site visits, communicating administrative and
programmatic changes, conducting provider education and offers
resolution of provider issues. You will serve as a knowledge and
resource expert regarding provider issues impacting provider
satisfaction, research and resolve complex provider issues and
appeals for prompt resolution for HealthyBlue, NC plan.--
- May be responsible for coordinating non-negotiated contracts
for new and existing providers as needed.
- Researches, analyzes and recommends resolution for contract
disputes, non-routine claim issues, billing questions and other
- Conducts seminars to support the understanding of managed care
policies and procedures.
- Identifies network access and deficiencies and develops
recruitment and contracting strategies.
- Coordinates and conducts provider training including developing
and distributing provider relations materials.
- Responsible for providing quality, accessible and comprehensive
service to the company's provider community.
- Provides assistance regarding education, contract questions and
non-routine claim issues.
- Coordinates communications process on such issues as
administrative and medical policy, reimbursement and provider
- Coordinates prompt claims resolution through direct contact
with providers, claims, pricing and medical management department.
Identifies and reports on provider utilization patterns which have
a direct impact on the quality of service delivery.
- Tracks and conducts provider refresher training.
- Researches issues that may impact future provider negotiations
or jeopardize network retention. Qualifications Additional
- Managed care experience to include provider training
orientations, claims resolution (end to end) and medical policy
- Provider Relations/Provider customer service experience
- Network contracting experience preferred.
- Excellent verbal and written communication skills.
- May require up to 80% day travel. Systems:
- Sharepoint Requires a Bachelor's degree; 3 years of customer
service experience including 2 years' experience as a Network
Management Rep; or any combination of education and experience,
which would provide an equivalent background. Travel may be
Anthem, Inc. is ranked as one of America's Most Admired Companies
among health insurers by Fortune magazine and has been named a 2019
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. 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. EEO is the Law Please use the links
below to review statements of protection from discrimination under
Federal law for job applicants and employees. Anthem, Inc. is
committed to helping individuals with disabilities participate in
the workforce and ensuring equal opportunity to apply and compete
for jobs. If you are an individual with a disability and require a
reasonable accommodation to complete the application process,
please email Human Resources at email@example.com for further
assistance. *WARNING : Please beware of phishing scams that solicit
interviews or promote work-at-home opportunities, some of which may
pose as legitimate companies. Please be advised that Anthem will
never ask you for a credit card, send you a check, or ask you for
any type of payment as part of consideration for employment with
our company. If you feel that you have been the victim of a scam
such as this, please report the incident to the Federal Trade
Commission here by selecting the 'Rip-offs and Imposter Scams'
option. Anthem requires a completed online application for
consideration of employment for any position.
Keywords: Anthem, Inc., Raleigh , Network Relations Consultant, Professions , Raleigh, North Carolina
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