Provider Network Manager Sr (US)

Elevance Health • Indianapolis, IN

21h • Hybrid

About The Position

Provider Network Manager Sr Location: 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 virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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. The Provider Network Manager Sr will be responsible for developing 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. How you will make an impact: 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.

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.
• Travels to worksite and other locations as necessary.

Nice To Haves

• Experience with value-based contracting, including shared savings and total cost of care models preferred.
• Experience with dialysis and/or outpatient facility/ancillary contracting experience across Commercial, Medicare and Medicaid products preferred.
• Contracting experience across multiple markets/states, preferably national contracting experience preferred.
• Experience drafting contract language preferred.
• Master's degree - MBA, MPH or similar preferred.

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

• 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).
• merit increases
• paid holidays
• Paid Time Off
• 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
• financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level