Manager Provider Network Management-LTSS (Wisconsin Family Care)

Location: WI-Waukesha, N17W24222 Riverwood Dr., Ste 300

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

The Manager Provider Network Management-LTSS (Wisconsin Family Care) manages a team responsible for provider relations and contracting within the Long-Term Services and Supports (LTSS) network across Wisconsin’s Family Care Program. This role focuses on maintaining strong relationships with home-and community-based service (HCBS) providers and ensuring network adequacy, compliance and quality alignment with state and program requirements.

How you will make an impact:

• Effectively manages the provider relations and contracting team to meet or exceed network performance goals, ensuring access to high-quality LTSS services and cost efficiency.
• Understands and manages budget performance across LTSS, Home Health, Residential and Community-based providers, ensuring rate structures and contracting models align with state guidance and program budgets.
• Oversees provider contracting strategies, including alternative payment models and value-based contracting applicable to Family Care and HCBS providers.
• Builds and maintains strong relationships with provider organizations, advocacy groups, and regulatory partners to support provider engagement and member access
• Hires, trains, coaches, counsels, and evaluates performance of direct reports, fostering a culture of accountability and continuous improvement.

Minimum Requirements:

• Requires a BA/BS degree in a related field and a minimum of 5 years equivalent work experience in provider contracting; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Strongly preferred a minimum of 8 years provider relations, LTSS network development, or managed LTSS.
• Knowledge of Wisconsin Medicaid and Family Care program requirements and reimbursement methodologies.
• Experience with HCBS providers, including residential, personal care, home health, and supportive employment services.
• Strong project management and data analysis experience with a focus on provider performance and cost trends.

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.

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 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.

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 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 elevancehealthjobssupport@elevancehealth.com 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.