Provider Network Management Director

Elevance Health • Atlanta, GA

33d • Hybrid

About The Position

Provider Network Management Director Location: 740 W Peachtree St. NW. Atlanta GA. 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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered for employment, unless an accommodation is granted as required by law The Provider Network Management Director develops the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed and hospital based, and hospital owned ancillary providers. The primary focus of this role is contracting and negotiating contract terms. Deals with only the most complex health systems, affiliated providers and drives and support value base initiatives. How you will make an impact: 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. 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. Fee schedules are customized. 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. May collaborate with the 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. Travels to worksite and other locations as necessary.

Requirements

• Requires a BA/BS degree and a minimum of 8 years of 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

• Experience using financial models and analysis to negotiate rates with providers is strongly preferred.
• Prior contract negotiation and financial analysis experience is strongly preferred.
• Strategic Thinking: Capability to align contract strategies with the organization's overall business goals and objectives preferred.
• Analytical Skills: Strong analytical skills to evaluate complex contracts, identify potential risks, and develop strategies to mitigate those risks is strongly preferred.
• Attention to Detail: High level of attention to detail to ensure accuracy and compliance with contracting processes is preferred.
• Problem-Solving: Ability to quickly identify issues and develop effective solutions is preferred.
• Communication Skills: Excellent verbal and written communication skills to clearly articulate contract terms and negotiate effectively with stakeholders is preferred.

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.
• 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.
• Fee schedules are customized.
• 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.
• May collaborate with the 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.
• Travels to worksite and other locations as necessary.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Industry: Insurance Carriers and Related Activities
• Number of Employees: 5,001-10,000 employees