Job Posting for Provider Network Management Director at Elevance Health
Location: Topeka KS, Kansas City KS
Hours: M – F Standard Working Hours
Travel: Hybrid (1-2 days onsite per week) In state travel to clients as needed
Position Overview
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.
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, 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
Required Qualifications
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 Qualifications
Experience using financial models and analysis to negotiate rates with providers strongly preferred
Travels to worksite and other locations as necessary
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