Provider Network Manager

Elevance Health•Mesa, AZ

16h•Hybrid

About The Position

The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and servicing. This role primarily focuses on contracting and negotiating contract terms with providers ranging from smaller institutional and professional providers to medical groups, physician groups, small hospitals, and ancillary providers. The role requires understanding value-based concepts and the ability to customize fee schedules. It involves working with increased independence and judgment, potentially collaborating on cross-functional projects, and serving as a communication link between providers and the company. The position requires conducting complex negotiations, drafting documents, assisting with financial projections and analysis, and traveling to worksites as necessary. The role is field-based, requiring travel throughout Arizona, with occasional office attendance. Candidates must be based in Arizona and within a reasonable commuting distance.

Requirements

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.
Candidates must be based in Arizona.
Willing to travel throughout the state of Arizona.

Nice To Haves

Value-based concepts understanding.

Responsibilities

Develops the provider network through contract negotiations (language and rates), relationship development, and servicing.
Contracts and negotiates contract terms with providers.
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, and ancillary providers.
Negotiates contracts that may involve non-standard arrangements requiring a moderate level of negotiation skills.
Demonstrates understanding of value-based concepts.
Customizes fee schedules.
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.