Provider Network Management Director-Hospital Experience Strongly Preferred

Elevance Health • Saint Louis, MO

243d

About The Position

The Provider Network Management Director is responsible for developing provider networks through contract negotiations, relationship development, and servicing for large strategic ancillary providers. The primary focus of this role is contracting and negotiating contract terms. This position will work a hybrid model (1-2 days/week in office) and the ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

Requirements

• Requires a BA/BS degree and a minimum of 8 years' experience in contracting, provider relations, and provider servicing.
• Experience must include prior contracting experience.

Nice To Haves

• Extensive experience analyzing data to support strategic contracting decisions strongly preferred.
• 5-10 years reviewing and negotiating complex, non-standard contracts strongly preferred.
• Experience working with large hospital system contracts with >$200,000,000 in spending strongly preferred.
• Advanced knowledge in SPS, Contraxx, PLM2, and Cost of Care (CofC) strongly preferred.
• Ability to present at a high level to C-Suite stakeholders strongly preferred.
• Experience partnering across all lines of businesses to include Commercial, Medicare, and Medicaid is strongly preferred.
• Experience with collaborative strategic provider relationship initiatives preferred.
• Project management experience preferred.
• PMP certification is a plus.

Responsibilities

• Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
• Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process.
• Typically serves as lead contractor for large scale, multi-faceted negotiations.
• Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.
• May assist management in network development planning.
• May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
• Contracts involve non-standard arrangements that require a high level of negotiation skills.
• Works independently and requires high level of judgment and discretion.
• May work on projects impacting the business unit requiring collaboration with other key areas.
• May collaborate with sales team in making presentations to employer groups.
• Serves as a communication link between providers and the company.
• Conducts the most complex negotiations.
• Prepares financial projections and conducts analysis.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree