Director Network Management-South Carolina at Elevance Health in Greenville, South Carolina

Job Description:

The Director Network Management is responsible for network development, provider engagement and management, and oversight of value-based payment innovation programs for the South Carolina market.



Location: This position will work a hybrid model (remote and office). Must reside within 50 miles/1 hour commute of our Columbia, SC office.



How you will make an impact:

• Develops and implements network contracting and network expansion strategies, to include identifying and cultivating strategic alliances and building new network models with significant provider organizations.

• Provides strategic design and implementation of high-performance networks to include facility and provider performance incentives.

• Oversees contracting and maintenance of all facilities including hospitals, surgery centers, etc.

• Oversees the development, maintenance and reconciliation of physician risk contracts and capitated arrangement.

• Assists staff, as needed, during contract negotiations with high-volume provider groups or facilities.

• Develops innovative ways to maintain a cost-effective network with adequate access and positive working relationships with providers.

• Attracts, develops, and manages key contracting and servicing staff.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

• Requires a BS/BA degree in business administration or related healthcare field and a minimum of 8 years healthcare operations, finance, underwriting, actuary, network development and sales experience; or any combination of education and experience, which would provide an equivalent background.
  
  

• Strongly preferred CPA or MBA degree.

• Strong experience in contract negotiation, network development and provider relations.

• Value-Based program experience strongly preferred.

• Proven leadership experience with the ability to coach, develop and engage strong teams.