Provider Network Manager

Elevance Health • Monroe, WI

77d

About The Position

The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and servicing. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. The primary focus of this role is contracting and negotiating contract terms, typically working with less-complex to complex providers. Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, and providers in areas with increased competition or where greater provider education around managed care concepts is required. Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. The role requires an understanding of value-based concepts, and fee schedules can be customized. The Provider Network Manager works with increased independence and requires increased use of judgment and discretion, may work on cross-functional projects requiring collaboration with other key areas, serves as a communication link between professional providers and the company, conducts more complex negotiations and drafts documents, and assists in preparing financial projections and conducting analysis as required.

Requirements

• BA/BS degree.
• Minimum of 3 years' experience in contracting, provider relations, or provider servicing.
• Combination of education and experience providing an equivalent background.
• Ability to travel to worksite and other locations as necessary.

Responsibilities

• Develop the provider network through contract negotiations and relationship development.
• Negotiate contract terms with less-complex to complex providers.
• Work with various types of providers including smaller institutional providers and medical groups.
• Handle non-standard arrangements requiring negotiation skills.
• Understand value-based concepts and customize fee schedules.
• Work independently and use judgment and discretion.
• Collaborate on cross-functional projects.
• Serve as a communication link between providers and the company.
• Conduct complex negotiations and draft necessary documents.
• Assist in preparing financial projections and conducting analysis.

Benefits

• Merit increases.
• Paid holidays.
• Paid Time Off.
• Incentive bonus programs.
• Medical, dental, and vision benefits.
• Short and long term disability benefits.
• 401(k) with match.
• Stock purchase plan.
• Life insurance.
• Wellness programs.
• Financial education resources.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees