What are the responsibilities and job description for the Provider Network Manager Sr. position at Elevance Health?
Location : Elevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection. This includes remote work and 1-2 days in office per week. Candidates must reside within a 50-mile or 1-hour commute each way of a relevant Elevance Health location.
Is your CV ready If so, and you are confident this is the role for you, make sure to apply asap.
The Provider Network Manager Sr. develops the provider network through contract negotiations, relationship development, and servicing. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized.
How You Will Make an Impact
Primary duties may include, but are not limited to :
- Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
- Works independently and requires high level of judgment and discretion.
- May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
- May collaborate with sales team in making presentations to employer groups.
- Serves as a communication link between professional providers and the company.
- Ensure that network composition includes an appropriate distribution of provider specialties.
- Conducts more complex negotiations and drafts documents.
- Prepare financial projections and conduct analysis.
Minimum Requirements :
Requires a BA / BS degree and a minimum of 5 years’ experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences :
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
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