Director Provider Performance and Operations

Elevance Health•Boston, MA

1d•$147,660 - $221,490•Hybrid

About The Position

This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Director Provider Performance and Operations will direct the contract administration policies and standards and provides strategic oversight of contract administration function within a given unit. Identifies Contract Administration information needs and technologies. Develops and manages the annual operating budget within financial objectives and in a manner which goals are met. Directs the Contract Administration team and Technical team, ensuring our contract administration goals are obtained and maintained, working with Network Management, ASO Sales, IT and our Vendor. Manages the analysts and contractors to meet or exceed the health care target costs on a per unit basis. Oversees contracts with hospital, Primary and Specialty care practices. Manages contracting models, provider reimbursement, and risk modeling. Hires, trains, coaches, counsels and evaluates performance of direct reports. Supervises workflow and performance of subordinates. Ensures compliance with departmental policies and procedures. Provides quality control services by monitoring work results of direct reports. Performs audits to monitor efficiency and compliance with policies. Develops and implements associate training. Prepares reports. May be assigned to special project work consistent with the role and dictated by the needs of the business.

Requirements

Requires Bachelors degree in a related field and minimum of 5 years equivalent work experience in provider contracting, or any combination of education/experience that would provide an equivalent background.

Nice To Haves

Strongly preferred analytical and negotiation skills and PC proficiency.

Responsibilities

Directs the contract administration policies and standards and provides strategic oversight of contract administration function within a given unit.
Identifies Contract Administration information needs and technologies.
Develops and manages the annual operating budget within financial objectives and in a manner which goals are met.
Directs the Contract Administration team and Technical team, ensuring our contract administration goals are obtained and maintained, working with Network Management, ASO Sales, IT and our Vendor.
Manages the analysts and contractors to meet or exceed the health care target costs on a per unit basis.
Oversees contracts with hospital, Primary and Specialty care practices.
Manages contracting models, provider reimbursement, and risk modeling.
Hires, trains, coaches, counsels and evaluates performance of direct reports.
Supervises workflow and performance of subordinates.
Ensures compliance with departmental policies and procedures.
Provides quality control services by monitoring work results of direct reports.
Performs audits to monitor efficiency and compliance with policies.
Develops and implements associate training.
Prepares reports.
May be assigned to special project work consistent with the role and dictated by the needs of the business.