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Provider Network Mgmt Dir
Location:
MA, WOBURN
CA, WOODLAND HILLS
NJ, MORRISTOWN
WI, Waukesha
FL, MIAMI
IN, INDIANAPOLIS
OH, CINCINNATI
VA, RICHMOND
CA, WALNUT CREEK
KY, LOUISVILLE
NY, NEW YORK
WA, SEATTLE
NH, MANCHESTER
TX, GRAND PRAIRIE
IL, CHICAGO
MI, DEARBORN
TN, NASHVILLE
NY, MIDDLETOWN
LA, METAIRIE
MN, GILBERT
DC, WASHINGTON
GA, MIDLAND
NV, LAS VEGAS
MN, MENDOTA HEIGHTS
TX, HOUSTON
VA, NORFOLK
CT, WALLINGFORD
NC, CARY
MO, ST LOUIS
CA, COSTA MESA
MD, HANOVER
WV, CHARLESTON
NJ, ISELIN
DE, WILMINGTON
OH, MASON
OH, SEVEN HILLS
RI, SMITHFIELD
CO, DENVER
NV, LAS VEGAS
NC, WINSTON
ME, SOUTH PORTLAND
GA, ATLANTA
NY, LATHAM
OH, COLUMBUS
FL, TAMPA
IA, W DES MOINES
VA, ROANOKE
Description
Provider Network Mgmt Dir
Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint location listed on the requisition.
UniCare is a proud member of Elevance Health's family of brands, offering Medicaid plans to residents of West Virginia, as well as commercial and Medicare plans to members insured through the Commonwealth of Massachusetts Group Insurance Commission (GIC).
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. Primary focus of this role is contracting and negotiating contract terms. Deals with only the most complex health systems, affiliated providers and drives and support value base initiatives
How you will make an impact:
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.
Contracts involve non-standard arrangements that require a high level of negotiation skills.
Fee schedules are customized.
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 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.
Minimum Requirements:
Requires a BA/BS degree and a minimum of 8 years' 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.
Preferred Skills, Capabilities, and Experiences:
Experience using financial models and analysis to negotiate rates with providers strongly preferred.
Contracting experience highly preferred.
Previous experience leading design and execution of Value Based Payment Models highly preferred.
Experience and knowledge in healthcare industry is strongly preferred.
Excellent written, oral, presentation and interpersonal communication skills with the proven ability to negotiate expectations between multiple parties.
Experience interacting confidently with senior management, as s subject matter expert and comfortable with influencing decision-making.
Mastery of Microsoft Office products, most notably Excel, PowerPoint, Teams, Outlook, and Word strongly preferred.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $98,000 to $176,400
Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by t