Provider Network Manager Sr.
About The Position
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. 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 will be, but not limited to: contracting and negotiating Single Case Agreements. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups, value-based concepts, understanding and support. Contracts involve non-standard arrangements that require a high level of negotiation skills. PRIMARY DUTIES: May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management. Serves as key resource for other contracting staff. 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. 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.
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
- Intermediate Excel skills with the ability to analyze data.
- Transplant or cellular immunotherapy contracting experience.
- Commercial, Medicare, and / or Medicaid contracting experience.
- Strong negotiation skills, critical thinking, analytical skills, and knowledge of contract language.
Responsibilities
- Develops the provider network through contract negotiations, relationship development, and servicing.
- Contracting and negotiating Single Case Agreements.
- Works with the most complex providers.
- Works on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
- Serves as key resource for other contracting staff.
- 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.
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, 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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
