Provider Network Manager Sr (US) at Elevance Health

Middletown, New York, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

NoVisa

HealthcareIndustries

Requirements

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
Ability to work in-office 1-2 days per week (candidates not within reasonable commuting distance from posting locations will not be considered unless accommodation granted)
Not eligible for employment-based sponsorship

Responsibilities

Develops the provider network through contract negotiations, relationship development, and servicing (primary focus on contracting and negotiating Single Case Agreements)
Works with the most complex providers (e.g., large institutional providers, large medical groups, value-based concepts)
Handles non-standard arrangements requiring high level of negotiation skills
May work on projects impacting the business unit, requiring collaboration with other key areas or serving on enterprise projects around network management
Serves as key resource for other contracting staff
Works independently requiring high level of judgment and discretion
Serves as a communication link between professional providers and the company
Ensures that network composition includes an appropriate distribution of provider specialties
Conducts more complex negotiations and drafts documents

Skills

contract negotiations

provider network management

relationship development

Single Case Agreements

negotiation skills

value-based contracts

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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