Provider Network Manager Sr (US) at Elevance Health in Washington, Washington DC

Job Description:

Location:



Elevance Health supports a hybrid workplace model (virtual and office) with PulsePoint sites used for collaboration, community, and connection, with the minimum in-office commitment being 1-3 days in an office per week.


Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.



Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers,
Behavioral health groups and Psychiatric Facilities, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Experience with creating and customizing Fee schedules.



PRIMARY DUTIES:

• Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.


• 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 and provider network team in making presentations to internal and external stakeholders.


• Serves as a Subject Matter Expert and communication link between professional providers and the company.


• Ensure that network composition includes an appropriate distribution of provider specialties.


• Conducts more complex negotiations which may include financial impact, complex redlines and drafts documents for contracts.


• Prepare financial projections and conduct analysis.


• Works in collaboration with senior leadership to prepare presentations for DHCF and other government agencies.

Minimum Requirements:



Requires a BA/BS degree and a minimum of 5 years' experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.



Preferred Skills, Capabilities and Experience:

• Experience in fee schedule development using actuarial models strongly preferred.


• Travels to worksite and other locations as necessary.

For candidates working in person or remotely in the below location, the salary* range for this specific position is $90,300 to $148,350


Location: Washington, DC, Maryland


In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.


* The 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. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. 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. Apply Now