Provider Network Mgmt Dir

Elevance Health•Cincinnati, OH

1d•Hybrid

About The Position

The Provider Network Management Director will be responsible for developing the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed 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 drives and support value base initiatives. 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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.

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

Experience using financial models and analysis to negotiate rates with providers 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.
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 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.