Develops the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed and hospital based and hospital owned ancillary providers. Primary focus of this role is contracting and negotiating contract terms. Deals with only the most complex health systems, affiliated providers and drives and support value base initiatives.
Primary focus of this role is contracting and negotiating contract terms.
Deals with only the most complex health systems, affiliated providers and drives and support value base initiatives.
Primary duties may include, but are not limited to:
- 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, 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.
- Contracts involve non-standard 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.
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 Experience:
- Experience using financial models and analysis to negotiate rates with providers strongly preferred.
- California IPA and Hospital contracting experience
- May require travel up to 30%.
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 firstname.lastname@example.org for assistance.