Provider Network Manager

The Provider Network Manager develops the provider network through contract negotiations (language and rates), relationship development, and servicing., 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 accommodation is granted as required by law.

How will you make an impact:

• 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.
• Value based concepts understanding.
• 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.

• Requires 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.

Preferred Skills, Capabilities, and Experiences:

• Provider contracting and negotiation experience.
• Provider network management experience.
• Behavioral health experience preferred.
• Knowledge of value-based care and Kansas market preferred.
• Data analysis and reporting experience.
• Medicaid, Medicare, or Commercial network and experience.
• Candidates must reside in Kansas and be within a reasonable commuting distance of an Elevance Health PulsePoint office.

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 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 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.