Provider Network Management Director

Elevance Health • Overland Park, KS

76d

About The Position

Develops the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed, hospital based and hospital owned ancillary providers. Primary focus of this role is contracting and negotiating contract terms. Deals with only the most complex health systems, affiliated providers, and supports value base initiatives.

Requirements

• Requires a BA/BS degree and a minimum of 8 years' experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Candidate Must reside in Kansas
• Kansas Medicaid and Medicare strongly preferred
• Advanced Negotiation skills is a must have
• Experience using financial models and analysis to negotiate rates with providers strongly preferred
• Value Based/Alternative payment model experience strongly preferred
• Travels to worksite and other locations as necessary

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 and serves as subject matter expert for that area for a business unit
• 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 to include gap fill projects and network adequacy reporting
• 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
• Familiarity with customized Fee schedules
• Works independently and requires high level of judgment and discretion
• May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management
• 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: Director
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees