Network Education Representative/ Sr.
Description SHIFT:
Day Job SCHEDULE:
Full-time 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.
The Network Education Representative supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy.
Develops and provides a standard orientation package for newly contracted providers.
Promotes technology and skills development to improve provider business practices.
Primary duties may include, but are not limited to:
Provides/coordinates provider training for claims and billing procedures, contract compliance, medical management, and pharmacy issues.
Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
Facilities provider network by recruiting necessary PCP, Specialist, Ancillary, and Hospital providers and assisting Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.
Ensures member access to care through network maintenance, telemedicine site support, and recruitment of culturally and linguistically appropriate providers, as appropriate.
Network Education Rep Sr.
The Network Education Representative Sr.
supports provider network with all Commercial Risk Adjustment programs through customer service, training and education.
Responsible for promoting Commercial Risk Adjustment programs with Anthem's provider network.
Works as subject matter expert with regards to programs and manages all provider issues with regards to CRA programs.
Acts as liaison between local provider solutions team, provider network and Commercial Risk Adjustment team.
Primary duties may include, but are not limited to:
Provides/coordinates provider training for Commercial Risk Adjustment programs
Promotes Commercial Risk Adjustment programs through provider forums and trainings
Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations as it pertains to Commercial Risk Adjustment.
Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies.
Acts as a liaison between the Commercial Risk Adjustment team, Provider Solutions and the provider network.
Builds strategies unique to markets to help improve Risk Adjustment processes Qualifications Location:
Any Anthem office location Monitor your email for a ModernHire invitation please complete it within 48 hours Network Education Representative
Requires a BA/BS degree; 2 years' experience; or any combination of education and experience, which would provide an equivalent background.
May require state license in Life & Health.
Network Education Representative Sr.
Requires a BA/BS degree; 4 years' experience; or any combination of education and experience, which would provide an equivalent background.
Ideal candidate will possess excellent communication skills.
Prior experience dealing with provider groups and/or hospital systems preferred.
Preferred skills:
Must have strong verbal and written communication skills
Training experience is helpful
Ability to present/education Providers/groups on related topics
Self-motivator/able to work independently 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.
REQNUMBER:
PS42523.
Estimated Salary: $20 to $28 per hour based on qualifications.
Day Job SCHEDULE:
Full-time 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.
The Network Education Representative supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy.
Develops and provides a standard orientation package for newly contracted providers.
Promotes technology and skills development to improve provider business practices.
Primary duties may include, but are not limited to:
Provides/coordinates provider training for claims and billing procedures, contract compliance, medical management, and pharmacy issues.
Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
Facilities provider network by recruiting necessary PCP, Specialist, Ancillary, and Hospital providers and assisting Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.
Ensures member access to care through network maintenance, telemedicine site support, and recruitment of culturally and linguistically appropriate providers, as appropriate.
Network Education Rep Sr.
The Network Education Representative Sr.
supports provider network with all Commercial Risk Adjustment programs through customer service, training and education.
Responsible for promoting Commercial Risk Adjustment programs with Anthem's provider network.
Works as subject matter expert with regards to programs and manages all provider issues with regards to CRA programs.
Acts as liaison between local provider solutions team, provider network and Commercial Risk Adjustment team.
Primary duties may include, but are not limited to:
Provides/coordinates provider training for Commercial Risk Adjustment programs
Promotes Commercial Risk Adjustment programs through provider forums and trainings
Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations as it pertains to Commercial Risk Adjustment.
Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies.
Acts as a liaison between the Commercial Risk Adjustment team, Provider Solutions and the provider network.
Builds strategies unique to markets to help improve Risk Adjustment processes Qualifications Location:
Any Anthem office location Monitor your email for a ModernHire invitation please complete it within 48 hours Network Education Representative
Requires a BA/BS degree; 2 years' experience; or any combination of education and experience, which would provide an equivalent background.
May require state license in Life & Health.
Network Education Representative Sr.
Requires a BA/BS degree; 4 years' experience; or any combination of education and experience, which would provide an equivalent background.
Ideal candidate will possess excellent communication skills.
Prior experience dealing with provider groups and/or hospital systems preferred.
Preferred skills:
Must have strong verbal and written communication skills
Training experience is helpful
Ability to present/education Providers/groups on related topics
Self-motivator/able to work independently 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.
REQNUMBER:
PS42523.
Estimated Salary: $20 to $28 per hour based on qualifications.
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