Provider Network Manager - New York

Elevance Health • Latham, NY

5d • Hybrid

About The Position

Provider Network Manager - New York Candidate Must Reside in or near the state of New York. This is an Individual Contributor role. Location: Hybrid 1 - 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 resides 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, 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. Work Shift: Monday – Friday, 40 hours a week The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and working with New York state regulations (i.e. HPN/PNDS reviews, NQTL).

Requirements

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

Nice To Haves

• Project Management experience highly preferred.
• Analytics experience.
• Advanced user level using MS Excel, such as Vlook up.
• Proficient with PowerBI.

Responsibilities

• Works closely with director on New York state project initiatives.
• Assists with contracting and negotiating contract terms.
• Typically works 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, providers in areas with increased competition or where greater provider education around managed care concepts is required.
• Works with contracts that may involve non-standard arrangements that require a moderate level of negotiation skills.
• Assists in preparing financial projections and conducting analysis as needed.
• 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.
• 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).
• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level