Provider Network Manager

Elevance Health•Overland Park, KS

1d•Hybrid

About The Position

The Provider Network Manager is responsible for developing the provider network through contract negotiations (language and rates), relationship development, and servicing. This role typically works with less-complex to complex providers, including 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 and an understanding of value-based concepts. Fee schedules can be customized. The role involves working with increased independence, requiring judgment and discretion, and may involve cross-functional projects. The Provider Network Manager serves as a communication link between professional providers and the company, conducts more complex negotiations, drafts documents, and assists in preparing financial projections and conducting analysis.

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

Travels to worksite and other locations as necessary.
Understanding of value based concepts.
Moderate level of negotiation skills.

Responsibilities

Developing the provider network through contract negotiations (language and rates), relationship development, and servicing.
Working with less-complex to complex providers, including 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.
Negotiating contracts that may involve non-standard arrangements and require a moderate level of negotiation skills.
Understanding value-based concepts.
Customizing fee schedules.
Working with increased independence and exercising judgment and discretion.
Collaborating on cross-functional projects.
Serving as a communication link between professional providers and the company.
Conducting more complex negotiations and drafting documents.
Assisting in preparing financial projections and conducting analysis.