Provider Network Management Director

Elevance Health • Mesa, CA

1d • Hybrid

About The Position

Provider Network Management Director A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. 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. 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.

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

• Strong experience conducting thorough research and applying well-reasoned judgment to inform decisions.
• Experience building strong cross-functional relationships to ensure timely resolution of escalations.
• Experience using financial models and analysis to negotiate rates with providers strongly 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 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

• Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• 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