Provider Network Manager
Elevance Health

Job Info

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The Provider Network Manager is develops the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with less-complex to complex providers. Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required.

• Contracts may involve non-standard arrangements that require a moderate level of negotiation skills.
• Value based concepts understanding.
• Fee schedules can be customized.
• Works with increased independence and requires increased use of judgment and discretion.
• May work on cross-functional projects requiring collaboration with other key areas.
• Serves as a communication link between professional providers and the company.
• Conducts more complex negotiations and drafts documents.
• Assists in preparing financial projections and conducting analysis as required.

Requirements:

• a BA/BS degree and a minimum of 3 years' experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.
• Travels to worksite and other locations as necessary.

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