Provider Network Management Director (US)

Elevance Health (Anthem); Nevada (IA); Hybrid; USD 103,000 - 178,000; Full time

Benefits offered by this job

Benefits package

Equity stock purchase

401(k) plan

Incentive programs

Job summary

Elevance Health is seeking a Provider Network Management Director to lead contracting efforts for Nevada and other regions within the health network. The role emphasizes complex negotiations, relationship building with large health systems, and strategic network development.

The position requires strong leadership, extensive contracting experience, and the ability to collaborate across business units while traveling as needed. Hybrid in-office and virtual work model with required PST hours.

Qualifications

• Requires BA/BS degree and 8+ years contracting experience.
• Experience negotiating complex contracts with large health systems.
• Experience using financial models to negotiate rates.

Responsibilities

• Lead associate resources and projects in network management.
• Serve as SME for local contracting efforts and enterprise initiatives.
• Lead large-scale negotiations for complex contracts.
• Prepare financial projections and analyses.
• Travel to worksite and other locations as necessary.

Skills

Contracting

Negotiation

Provider relations

ACO development

Education

BA/BS degree

Job description

Provider Network Management Director

Location: This role requires associates to be in-office 3 days 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 if candidates reside within a commuting distance from an office. Must be willing to work PST hours.

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 Provider Network Management Director develops the Nevada 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.
• Travels to worksite and other locations as necessary.

Minimum Qualifications:

• 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.
• Demonstrated experience negotiating and managing complex contracts with large health systems within the Commercial line of business strongly preferred.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $103,120 to $177,882.

Location(s): Costa Mesa, CA; Woodland Hills, CA; Chicago, IL; Las Vegas, NV; Norfolk, VA; Seattle, WA.

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 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 s