Provider Network Management Director
Provider Network Management Director
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Job Description
Anticipated End Date:
Position Title:
Provider Network Management DirectorJob Description:
Provider Network Management Director
Location: Alternate locations may be considered. This position will work a hybrid model 12 days/week in office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
The Provider Network Management Director is responsible developing provider networks through contract negotiations relationship development and servicing for large strategic ancillary providers. Primary focus of this role is contracting and negotiating contract terms.
How you will make an impact:
- Serves in a leadership capacity leading associate resources special projects/initiatives or network planning.
- Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit. Typically serves as lead contractor for large scale multifaceted negotiations.
- Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.
- May assist management in network development planning.
- May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
- Contracts involve nonstandard arrangements that require a high level of negotiation skills. Fee schedules are customized.
- 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 providers and the company.
- Conducts the most complex negotiations.
- Prepares financial projections and conducts analysis.
Minimum Requirements:
- Requires a BA/BS degree and a minimum of 8 years experience in contracting (value based shared savings and ACO development) provider relations provider servicing; experience must include prior contracting experience; or any combination of education and experience which would provide an equivalent background.
Preferred Skills Capabilities and Experiences:
- Extensive experience analyzing data to support strategic contracting decisions strongly preferred.
- 510 years reviewing and negotiating complex nonstandard contracts strongly preferred.
- Experience working with large hospital system contracts with >$in spending strongly preferred.
- Advanced knowledge in SPS Contraxx PLM2 and Cost of Care (CofC) strongly preferred.
- Ability to present at a high level to CSuite stakeholders strongly preferred..
- Experience partnering across all lines of businesses to include Commercial Medicare and Medicaid is strongly preferred.
- Experience with collaborative strategic provider relationship initiatives preferred.
- Project management experience preferred.
- PMP certification is a plus.
- Travels to worksites and other locations may be necessary.
Job Level:
Director EquivalentWorkshift:
Job Family:
PND > Network ContractingPlease 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.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success for our consumers our associates our communities and our business.
We offer a range of marketcompetitive 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.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/memberfacing roles to become vaccinated against COVID19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Required Experience:
Director
Employment Type
Full-Time
