Network Relations Consultant (Miamisburg, OH) - 64302 PI
WellPoint - Miamisburg, OH

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Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to improving the lives of the people we serve and the health of our communities.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

Network Relations Consultant

Responsibilities include financial and data analysis and reporting, payment innovation development and operational support, and develop and maintain positive relationships with providers with a focus on strategies for recruitment and contracting. Primary duties may include, but are not limited to: Research and analyzing utilization and financial data to develop cost of care improvement strategies. Coordination and implementation of provider payment innovation programs. Conducts negotiations and leads contracting efforts with providers to build and maintain a cost effective, accessible provider network. Develops and maintains positive relationships with the provider community by periodic on-site visits, communicating administrative or programmatic changes and facilitating the resolution of provider issues. Recruits providers to build a cost effective, high quality provider network. Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices. Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.

Job Qualifications

Requires a BA/BS degree; 3 years of related experience (provider relations, network management, customer service, sales-negotiation); prior negotiation experience; or any combination of education and experience, which would provide an equivalent background. Previous experience in provider negotiations and corresponding financial analysis in addition to strong communication, analytical and negotiation skills required. Payment innovation, project management and data analysis experience preferred.

WellPoint is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2012 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at
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).

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WellPoint, Inc. (WellPoint) is a health benefits company serving 35 million medical members, as of December 31, 2008. The Company is an...