Provider Network Management Director at Elevance Health

Atlanta, Georgia, United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

BA/BS degree
Minimum of 8 years of 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
Ability to work in-office 3 days per week at 740 W Peachtree St. NW, Atlanta, GA (candidates not within reasonable commuting distance will not be considered unless accommodation granted as required by law)

Responsibilities

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
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
Handles contracts involving non-standard arrangements that require a high level of negotiation skills
Manages customized fee schedules
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 the 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
Travels to worksite and other locations as necessary

Skills

Key technologies and capabilities for this role

Contract NegotiationProvider Network ManagementRelationship DevelopmentValue-Based InitiativesLeadershipNetwork PlanningMentoring

Questions & Answers

Common questions about this position

What is the work arrangement for this role?

This role requires associates to be in-office 3 days per week at 740 W Peachtree St. NW, Atlanta GA, with flexibility for virtual work the other days. Candidates not within a reasonable commuting distance from the location will not be considered unless an accommodation is granted as required by law.

What are the minimum education and experience requirements?

The role requires a BA/BS degree and a minimum of 8 years of experience in contracting (value based, shared savings and ACO development), provider relations, or provider servicing, with prior contracting experience included.

What salary or compensation is offered for this position?

This information is not specified in the job description.

What does the company culture emphasize in this role?

The culture promotes a dynamic and adaptable workplace that combines structured office engagement 3 days per week with virtual work flexibility to foster collaboration, connectivity, productivity, and work-life balance.

What makes a strong candidate for this Director role?

Strong candidates will have a BA/BS degree, 8+ years in contracting including value-based arrangements, shared savings, and ACO development, plus expertise in complex negotiations, provider relations, financial analysis, and leadership of teams or projects.

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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