Provider Network Manager at Elevance Health

Las Vegas, Nevada, United States

Elevance Health Logo
Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Behavioral Health, Mental HealthIndustries

Requirements

  • 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
  • Ability to travel to worksite and other locations as necessary
  • Reside within a reasonable commuting distance from the posting location (9133 W. Russell Rd, Las Vegas, NV) or alternate locations considered if within commuting distance

Responsibilities

  • Develops the provider network through contract negotiations (language and rates), relationship development, and servicing
  • Primary focus on contracting and negotiating contract terms with less-complex to complex providers (e.g., smaller institutional providers, professional providers with complex contracts, medical groups, physician groups, small hospitals, ancillary providers)
  • Works with providers in areas with increased competition or where greater provider education around managed care concepts is required
  • Handles contracts involving non-standard arrangements requiring moderate level of negotiation skills
  • Demonstrates understanding of value-based concepts
  • Customizes fee schedules
  • Works with increased independence using judgment and discretion
  • Participates in 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

Skills

Key technologies and capabilities for this role

contract negotiationprovider relationsnetwork developmentrate negotiationrelationship managementhealthcare contractingprovider servicing

Questions & Answers

Common questions about this position

What is the salary range for the Provider Network Manager position?

For candidates working in person or virtually in the specified locations, the salary range for this position is $66,048-$103,572.

Is this a remote position, or does it require office presence?

This is a hybrid role requiring associates to be in-office 1-2 days per week at 9133 W. Russell Rd, Las Vegas, NV, to foster collaboration while providing flexibility. Candidates must reside within a reasonable commuting distance from the office, unless an accommodation is granted.

What skills and experience are required for the Provider Network Manager role?

A BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, or provider servicing are required. Key skills include contract negotiations, relationship development, value-based concepts understanding, and conducting complex negotiations.

What is the work environment like at Carelon Behavioral Health?

The role is part of an extraordinary team at Carelon Behavioral Health, a member of Elevance Health, focused on superior clinical mental health services and fostering collaboration through a hybrid model that balances office engagement with flexibility.

What makes a strong candidate for the Provider Network Manager position?

Strong candidates have a BA/BS degree with 3+ years in contracting, provider relations, or servicing, experience with complex negotiations, value-based contracts, and the ability to work independently on cross-functional 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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