Provider Network Manager Sr

Elevance HealthGrand Prairie, TX
Hybrid

About The Position

JR183772 Provider Network Manager Sr The Provider Network Manager Sr develops the provider network through contract negotiations, relationship development, and servicing. Location: Hybrid 1: This role requires associates to be in-office 1 day 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. 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 accommodation is granted as required by law. At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading. Join our Talent Community and stay connected with company news, information, and future job opportunities. Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner. Our nearly 100,000 associates serve approximately 100M+ people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration Please visit the Contract Worker Community Page. Elevance Health is an Equal Opportunity Employer/Disability/Veterans.

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

  • Strong provider and facility contracting experience is critical for success in this role, including complex negotiations, rate development, reimbursement modeling, and contract execution within highly regulated environments.
  • Texas Medicaid managed care experience highly preferred, including familiarity with HHSC requirements, waiver programs, and state-specific compliance standards.
  • Experience contracting with behavioral health providers strongly preferred.
  • Extensive Managed Care Organization (MCO) and/or Texas health plan experience, including understanding of network adequacy, value-based arrangements, performance metrics, and quality standards.
  • Ability to collaborate cross-functionally with clinical, operations, compliance, and sales teams to support network growth and market strategy.

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.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Number of Employees

5,001-10,000 employees

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