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Provider Network Management Director

Location:

  • IN, Indianapolis
  • OH, Mason
  • MO, St. Louis
  • KY, Louisville
  • CO, Denver
  • VA, Virginia Beach
  • GA, Atlanta

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Description

Location: open to a fully remote arrangement or any location

The Provider Network Management Director will support the National Contracting, Elevance Health Centers of Excellence team and is responsible for network development and the provider network through contract negotiations, relationship development, and servicing for large health systems and includes multiple provider types, ancillary, hospitals and physicians (not just one of these provider types). Primary focus of this role is contracting and negotiating contract terms. Spends a minimum of 50% of the time either in a leadership role or that of subject matter expert and deals with only the most complex providers.

How you will make an impact:

  • Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
  • Performs complex market and competitive analysis, engages provider clinical teams and Elevance Health cross-functional teams, creates Global Value Based Payment concepts.
  • Serves as a subject matter expert for enterprise 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, multi-faceted 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.
  • Works with the most complex providers such as institutional providers, large medical groups and ancillary providers, and providers in areas with significant competition.
  • Contracts involve non-standard arrangements that require a high level of negotiation skills.
  •  Reimbursement methodologies are typically 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 contracting strategies and implementation.
  • 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 8-10 years of experience in contracting large hospital systems, large single-specialty physician groups and/or large faculty practice plans, or any combination of education and experience, which would provide an equivalent background.

Preferred skills, capabilities, and experiences: 

Previous experience with Centers of Excellence contracting and execution of Global Value-Based Payment Models is preferred. 

Previous experience with cardiac, spine, and/or joint replacement Centers of Excellence contracting is highly preferred. 

Requires light travel (less than 20%). 

Preferred Master's Degree in Business or Healthcare. 

Proficiency with Excel, Word and PowerPoint is essential. 

Strong negotiation skills, critical thinking, analytical skills, and knowledge of contract language. 

Applicable to Colorado Applicants Only

Annual Salary Range*: $102,500 - $128,200

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

* The hourly or salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting.  The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future.  No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive 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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. 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 ability@icareerhelp.com for assistance.

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