Provider Network Management Director at Elevance Health

Atlanta, Georgia, United States

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Not SpecifiedCompensation

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 in 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
Conducts the most complex negotiations involving non-standard arrangements that require a high level of negotiation skills and 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
Prepares financial projections and conducts analysis
Travels to worksite and other locations as necessary

Skills

Contract Negotiation

Provider Network Management

Relationship Development

Value-Based Initiatives

Leadership

Mentoring

Network Planning

Strategic Contracting

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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