22 Aug
Program Consultant
California, Newburypark 00000 Newburypark USA

Vacancy expired!

Description SHIFT: Day JobSCHEDULE: Full-timeYour 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 benefits companies and a Fortune Top 50 Company.Responsible for the development and ongoing management of one or more external client facing programs within a business unit. Program consultants typically support business strategies through an integrated portfolio of external client facing projects or initiatives.Primary duties may include, but are not limited to:

Manages the development, approval, implementation and compliance of on-going external client facing programs; develops program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day to day business issues.

Researches applicable subject matter practices and remains aware of industry trends.

Manages relationships and partners with corporate and regional business areas; coordinates training related to the external client facing program; develops program success measures and performs periodic assessments of external client facing program success.

Qualifications

Requires a BA/BS in a related field; 3-5 years of experience in external client facing program management; or any combination of education and experience, which would provide an equivalent background. Graduate degree, professional designation related to field or project management experience preferred.

Conducts analyses of provider network structures, overlaps (ex. PCP crossovers) to support addition, termination or changes to delegated physician group networks.

Works closely with contracting, provider relations and operations teams to support execution of provider additions, terminations, or changes.

Assists with analyses of networks to respond to compliance inquiries.

Reviews networks for opportunities to convert from feefor-service to risk, or other CoC opportunities.

Experience pulling provider data from databases and manipulating it required.

Understanding of MediCal and CA managed care concepts preferred, but not required.

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.REQNUMBER: PS37802

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