Provider Network Manager Sr- Facility Contracting
About The Position
Location: 15 PLAZA DR Latham, NY This role requires associates to be in-office 1-2 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 remote 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(s) will not be considered for employment, unless an accommodation is granted as required by law. This position is not eligible for employment based sponsorship. Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized.
Requirements
- Requires a BA/BS degree and a minimum of 5 years' experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Nice To Haves
- Experience in fee schedule development using actuarial models strongly preferred.
- Travels to worksite and other locations as necessary.
Responsibilities
- Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
- 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 professional providers and the company.
- Ensure that network composition includes an appropriate distribution of provider specialties.
- Conducts more complex negotiations and drafts documents.
- Prepare financial projections and conduct analysis
Benefits
- In addition to your salary, 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).
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Insurance Carriers and Related Activities
Number of Employees
5,001-10,000 employees
