Mgr II Provider Network Mgt/Relations - Texas Medicare/Medicaid - 98602

Company Name:
Amerigroup , a proud member of the Anthem, Inc . family of companies, is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities.
Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates are transforming health care with trusted and caring solutions.
Location: This position will allow you to work from home but you will need to reside in one of the following areas: Houston, Ft. Worth, San Antonio, or El Paso
The Manager ll Provider Network Management Relations is responsible for doing all, or some, of the following for a region within the Texas Medicare/Medicaid Duals Demo division. Manages hospital, ancillary, physician, behavioral health, and vendor contracting functions. Develops, implements and maintains the health plan provider network. Develops and expands health plan provider network, addresses network deficiencies, resolves provider complaints and ensures satisfaction, and coordinates contracting and management of health plan vendor relationships. Manages the servicing and contracting of providers with standard contracts. Primary duties may include, but are not limited to:
Coordinates provider network related activities in conjunction with the appropriate home office and local health plan staff.
Develops and implements provider agreements.
Negotiates contracts with providers statewide.
In conjunction with leadership, develops strategy to develop the provider network for the health plan.
Manages provider relations issue resolution, education/orientation, evaluation of network adequacy, recruitment and marketing related to providers.
Hires, trains, coaches, counsels, and evaluations the performance of direct reports.
BA/BS degree; 7 years experience in managed care contracting and/or network management; 3 years management experience; or any combination of education/experience which would provide an equivalent background.
1 - 3 years Medicaid/Medicare experience highly preferred
/Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us /. EOE. M/F/Disability/Veteran./ /
Job Provider Network Management
Title: Mgr II Provider Network Mgt/Relations - Texas Medicare/Medicaid - 98602
Location: Texas
Other Locations: TX-Grand Prairie, TX-El Paso, TX-Houston, TX-Fort Worth, TX-Dallas
Requisition ID: 98602

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