Provider Network Manager Sr (US) at Elevance Health

Middletown, New York, United States

Elevance Health Logo
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

Key technologies and capabilities for this role

contract negotiationsprovider network managementrelationship developmentSingle Case Agreementsnegotiation skillsvalue-based contracts

Questions & Answers

Common questions about this position

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

For candidates working in person or virtually in Columbus, OH or New York, the salary range is $86,000 to $141,900.

What is the work arrangement or location policy for this role?

This role requires associates to be in-office 1-2 days per week, with flexibility for remote work otherwise. Candidates must be within a reasonable commuting distance from the posting locations (Columbus, OH; New York), unless an accommodation is granted.

What are the minimum requirements and key skills for this position?

Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, or provider servicing, including prior contracting experience. Preferred skills include intermediate Excel skills, transplant or cellular immunotherapy contracting experience, commercial/Medicare/Medicaid contracting, strong negotiation skills, critical thinking, analytical skills, and knowledge of contract language.

What benefits does Elevance Health offer for this role?

In addition to salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution, all subject to eligibility requirements.

What makes a strong candidate for this Provider Network Manager Sr role?

Strong candidates will have a BA/BS and 5+ years in contracting or provider relations, with preferred experience in complex negotiations like transplant contracting, Excel data analysis, and knowledge of commercial/Medicare/Medicaid 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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