Provider Network Manager

Elevance Health•Topeka, KS

1d•Hybrid

About The Position

The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and servicing. This role requires associates to be in-office 1 day 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. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. The primary focus of this role is 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. 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.

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.
Candidates must reside in Kansas and be within a reasonable commuting distance of an Elevance Health PulsePoint office.

Nice To Haves

Provider contracting and negotiation experience.
Provider network management experience.
Behavioral health experience preferred.
Knowledge of value-based care and Kansas market preferred.
Data analysis and reporting experience.
Medicaid, Medicare, or Commercial network and experience.

Responsibilities

Develops the provider network through contract negotiations (language and rates), relationship development, and servicing.
Contracts and negotiates contract terms.
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.
Conducts negotiations for contracts that may involve non-standard arrangements requiring a moderate level of negotiation skills.
Works with increased independence and uses 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.