Elevance Health
Provider Network Manager Sr (US)
Elevance Health, Nashville, Tennessee, United States, 37247
Anticipated End Date:
2025-04-04
Position Title:
Provider Network Manager Sr (US)
Job Description:
The Provider Network Manager Sr develops the provider network through contract negotiations, relationship development, and servicing. The primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers, which may include large institutional providers, large medical groups, ancillary providers, and more. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized. Primary duties may include, but are not limited to:
Serves as a key resource for other contracting staff and provides mentoring and on-the-job training and development.
Works independently and requires a 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 the sales team in making presentations to employer groups.
Serves as a communication link between professional providers and the company.
Ensures that network composition includes an appropriate distribution of provider specialties.
Conducts more complex negotiations and drafts documents.
Prepares financial projections and conducts analysis.
Requirements:
A BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, and provider servicing; experience should include prior contracting experience; or any combination of education and experience that would provide an equivalent background.
Experience in fee schedule development using actuarial models is strongly preferred.
Travels to worksite and other locations as necessary.
Job Level:
Non-Management Exempt
Workshift:
Job Family:
PND > Network Contracting
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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2025-04-04
Position Title:
Provider Network Manager Sr (US)
Job Description:
The Provider Network Manager Sr develops the provider network through contract negotiations, relationship development, and servicing. The primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers, which may include large institutional providers, large medical groups, ancillary providers, and more. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized. Primary duties may include, but are not limited to:
Serves as a key resource for other contracting staff and provides mentoring and on-the-job training and development.
Works independently and requires a 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 the sales team in making presentations to employer groups.
Serves as a communication link between professional providers and the company.
Ensures that network composition includes an appropriate distribution of provider specialties.
Conducts more complex negotiations and drafts documents.
Prepares financial projections and conducts analysis.
Requirements:
A BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, and provider servicing; experience should include prior contracting experience; or any combination of education and experience that would provide an equivalent background.
Experience in fee schedule development using actuarial models is strongly preferred.
Travels to worksite and other locations as necessary.
Job Level:
Non-Management Exempt
Workshift:
Job Family:
PND > Network Contracting
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.
#J-18808-Ljbffr