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Provider Network Mgr I, II or Sr (Ancillary Contracting) - 84340 PI

Company Name:
WellPoint-Caremore
Job Description
WellPoint is one of the nations leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are working together to transform health care with trusted and caring solutions.
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.
Preferred locations: Richmond, VA, Wallingford, CT and Manchester, NH
Provider Network Manager I
Responsible for developing the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. This level typically works with less complex providers which may include, but are not limited to, professional providers, practice groups, small medical groups, providers in less competitive markets, and providers with greater familiarity with managed care concepts. Contracts tend to be more standard and afford less opportunity for customization. Fee schedules are fairly standardized with reimbursement models limited and well-defined. May participate in intradepartmental projects or smaller projects impacting multiple departments. Operates with general supervision, elevating unusual situations to management as required. Essential duties may include, but are not limited to: Solicits participation in the network and conducts re-contracting efforts as needed. Serves as a communication link between professional providers and the company. Conducts limited negotiations and drafts documents. Assists in preparing financial projections as required. Performs other duties as assigned.
Provider Network Manager II
Responsible for developing the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. This level typically works with more complex providers at least 50% of the time. Complex providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required. Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. Fee schedules can be customized. Works with increased independence and requires increased use of judgment and discretion. Serves as resource for lower-leveled consultants. May work on cross-functional projects requiring collaboration with other key areas. May collaborate with sales team in making presentations to employer groups. Essential duties may include, but are not limited to: Serves as a communication link between professional providers and the company. Conducts more complex negotiations and drafts documents. Assists in preparing financial projections and conducting analysis as required. Performs other duties as assigned.
Provider Network Mgr Sr.
Responsible for developing the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. This level typically works with the most complex providers at least 50% of the time. Complex providers may include, but are not limited to institutional providers, professional providers with complex contracts, medical groups, ancillary providers, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are often customized. Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development. May serve as lead over a contracting team engaged in less complex negotiations. Works independently and requires high level of judgment and discretion. May work on cross-functional projects requiring collaboration with other key areas or serve on enterprise projects around network management as needed. May collaborate with sales team in making presentations to employer groups. Essential duties may include, but are not limited to: Serves as a communication link between providers and the company. Conducts more complex negotiations and drafts documents. May prepare financial projections and conduct analysis as required. Performs other duties as assigned.
Job Qualifications
Preferred locations: Richmond, VA, Wallingford, CT and Manchester, NH
Provider Network Manager I
Requires BA/BS and 2 years experience in contracting, provider relations, provider servicing or any combination of education and experience that would afford equivalent competencies. Ancillary contracting experience preferred. Must have strong oral and written communication skills, good analytical skills, and PC skills. Experience in market and network analysis preferred. Experience developing reimbursement and contracting strategies preferred. Requires travel.
Provider Network Manager II
Requires BA/BS, Masters degree preferred, and 3-5 years experience in contracting, provider relations, provider servicing or any combination of education and experience that would afford equivalent competencies. Ancillary contracting experience preferred. Must have strong oral and written communication skills, good analytical skills, and PC skills. Experience in market and network analysis preferred. Experience developing reimbursement and contracting strategies preferred. Requires travel.
Provider Network Mgr Sr.
Requires BA/BS and 5-7 years experience in contracting, provider relations, provider servicing or any combination of education and experience that would afford equivalent competencies. Ancillary contracting experience preferred. Experience should include prior contracting experience. Must have exceptional oral and written communication skills, strong analytical skills, and PC skills. Must demonstrate leadership skills. Requires travel.
_WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at_ _. EOE. M/F/Disability/Veteran.___
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Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.
WARNING : Please beware of phishing scams that promote work-at-home opportunities and may also pose as legitimate companies. Please be advised that a WellPoint recruiter will never ask you for a credit card or any type of payment as part of consideration for a role with our company. All of our careers require that you first complete an online application on our web site.
Job Post Date: 04/03/2014
Employer: WellPoint, Inc
Benefits: WellPoint''s Benefits
Location: VA , Richmond CT , Wallingford GA , Atlanta IN , Indianapolis KY , Louisville ME , South Portland MO , St. Louis NH , Manchester OH , Mason OH , Valley View OH , Worthington
Req ID: 84340

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