Provider Network Manager (US)

Network Services And Programs, Provider Network Manager

This role requires associates to be in-office one day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid / virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Network Services and Programs, Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with less-complex to complex providers. Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required.

Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. Fee schedules can be customized. Works with increased independence and requires increased use of judgment and discretion. May work on 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.

Requirements : a 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. Travels to worksite and other locations as necessary. Provider billing and coding experience preferred. Single Case Agreement experience preferred.

Locations : California; Colorado; Nevada

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.