Provider Network Manager
Elevance Health•Mesa, AZ
•Hybrid
About The Position
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 develops the provider network through contract negotiations (language and rates), relationship development, and servicing.
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.
Nice To Haves
- Value-based concepts understanding.
Responsibilities
- Develops the provider network through contract negotiations (language and rates), relationship development, and servicing.
- Primary focus of this role is contracting and negotiating contract terms.
- Works with less-complex to complex providers, which may include 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.
- Understands value-based concepts and can customize 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.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
