Provider Network Manager Sr

Elevance Health • Las Vegas, NV

1d • $91,812 - $144,276 • Remote

About The Position

This is an Individual Contributor Role. This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. A proud member of the Elevance Health family of companies, Carelon Behavioral Health uses our powerful combination of experience, expertise, dedication and compassion to see what's possible and what's better. Born out of one of the largest healthcare systems organization in the United States, our rich history gives us a unique and valuable perspective on how to solve the most pressing healthcare challenges. The Provider Network Manager Sr 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 and customized fee schedules.

Requirements

• Requires a BA/BS degree and a minimum of 5 years of 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.
• Strong project management skills
• Comprehensive negotiation skills supporting multi-service lines of business.

Responsibilities

• Serve as key resource for other contracting staff and provides mentoring and on-the-job training and development.
• Work 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.
• Serve as a communication link between professional providers and the company.
• Ensure that network composition includes an appropriate distribution of provider specialties.
• Conduct more complex negotiations and drafts documents.
• Prepare financial projections and conduct analysis.
• Travel to worksite and other locations as necessary.

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• Paid Time Off
• medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources

What This Job Offers

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