Provider Network Manager
About The Position
Provider Network Manager Primary Location: Costa Mesa, CA Additional Location(s): Denver, CO, Las Vegas, NV, Seattle, WA , Atlanta, GA, Lake Mary, FL Hybrid: 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 if candidates reside within a commuting distance from an office. 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. 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.
- 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.
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).
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
