Provider Network Management Director (Medicare Network Build)

Provider Network Management Director (Medicare Network Build)

The Provider Network Management Director develops the provider network in Arkansas 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 for Medicare, Medicaid, and ACA programs.

Primary duties may include, but are not limited to :

• 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 a subject matter expert for that area for a business unit.
• Typically serves as a lead contractor for large scale, multi-faceted negotiations.
• Serves as a 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 a 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 the 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 :

Preferred Skills, Capabilities and Experiences :

Job Level : Director Equivalent

Workshift : 1st Shift (United States of America)

Job Family : PND >

Network Contracting

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.

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 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.