Provider Network Manager

Elevance Health•Mesa, CA

5d•Hybrid

About The Position

Provider Network Manager A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. The Provider Network Manager is responsible for developing the provider network through research, issue/gap identification, contract negotiations (language and rates), relationship development, and servicing. How you will make an impact: Contracting and negotiating contract terms. Typically works with less-complex to complex providers and providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, groups, small facilities that are not part of a health system, 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. Value based concepts understanding. Fee schedules can be customized. 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. Assists in preparing financial projections and conducting analysis as required. Travels to worksite and other locations as necessary.

Requirements

Requires a BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Strong experience conducting thorough research and applying well-reasoned judgment to inform decisions.
Experience building strong cross-functional relationships to ensure timely resolution of escalations.

Responsibilities

Contracting and negotiating contract terms.
Works with less-complex to complex providers
Contracts may involve non-standard arrangements that require a moderate level of negotiation skills.
Value based concepts understanding.
Fee schedules can be customized.
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.
Assists in preparing financial projections and conducting analysis as required.
Travels to worksite and other locations as necessary.