Provider Network Manager Sr (Contract Negotiations)

Elevance Health; Manchester (NH); Hybrid; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Provider Network Manager Sr. to lead contract negotiations and develop provider relationships. This role combines strategic thinking with hands-on negotiation, focusing on complex providers and customized fee schedules. The ideal candidate will possess strong analytical skills and have a proven track record in contracting within a health plan or managed care setting. Join a company dedicated to improving lives and communities, where your contributions will significantly impact both members and the healthcare landscape. Enjoy a hybrid work environment that promotes flexibility while fostering collaboration.

Benefits

Merit Increases

Paid Holidays

PTO

Health Benefits

401(k) Match

Stock Purchase Plans

Life Insurance

Wellness Programs

Financial Education Resources

Qualifications

• 5+ years of experience in contracting or provider relations.
• Strong negotiation skills with complex providers.

Responsibilities

• Develop provider network through contract negotiations.
• Serve as a mentor for contracting staff and assist sales.

Skills

Contract Negotiation

Provider Relations

Project Management

Analytical Skills

Education

BA/BS degree

Job description

Associate Referral Bonus: $250

Provider Network Manager Sr. – Contract Negotiations (JR151123)

Location: This role requires associates to be in-office 2 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.

Travel: Limited travel within the state of New Hampshire.

Role Overview

The Provider Network Manager Sr develops the provider network through contract negotiations, relationship development, and servicing. The primary focus is on contracting and negotiating contract terms, often with the most complex providers, including large institutional providers, medical groups, and ancillary providers. The role involves understanding and supporting value-based concepts, especially in areas with strong competition or where provider education on managed care is needed. Contracts may involve non-standard arrangements requiring advanced negotiation skills, with fee schedules that are customized. Key responsibilities include:

• Serving as a key resource and mentor for other contracting staff.
• Working independently with high judgment and discretion.
• Collaborating on projects impacting the business unit and enterprise-wide network management.
• Assisting the sales team in presentations to employer groups.
• Acting as a communication link between providers and the company.
• Ensuring appropriate provider specialty distribution within the network.
• Conducting complex negotiations and drafting contractual documents.
• Preparing financial projections and conducting analyses.

Minimum Requirements

• BA/BS degree and at least 5 years of experience in contracting, provider relations, or provider servicing, including prior contracting experience, or equivalent education and experience.

Preferred Qualifications

• 3+ years of contract negotiation experience, preferably in a health plan or managed care setting.
• Experience with standard reimbursement methodologies.
• Fee schedule development using actuarial models (strongly preferred).
• Knowledge of value-based agreement components is a plus.
• Limited travel within New Hampshire.
• Project management skills.

Please note that Elevance Health only accepts resumes from agencies with a signed agreement. Unsolicited resumes are the property of Elevance Health.

Who We Are

Elevance Health is dedicated to improving lives and communities, making healthcare simpler. As a Fortune 25 company with a long-standing industry presence, we seek leaders passionate about impacting our members and communities.

How We Work

We foster a culture focused on strategic growth and personal/professional development. Our values guide us in achieving our strategy, powering business outcomes, and driving shared success for consumers, associates, communities, and the business.

Our total rewards include merit increases, paid holidays, PTO, bonus programs, health benefits, 401(k) match, stock purchase plans, life insurance, wellness programs, and financial education resources.

Our hybrid work strategy requires associates to work onsite at least once a week unless specified otherwise. Candidates must reside within 50 miles or a 1-hour commute of an Elevance Health location.

COVID-19 & Legal Compliance

We prioritize health and require certain roles to be vaccinated against COVID-19 and Influenza, unless an exemption is provided. We comply with all relevant laws regarding employment and accommodations.

Equal Opportunity Employment

Elevance Health is an EEOC employer. We consider all qualified applicants without regard to protected statuses. Accommodation requests can be directed to [e-mail]. We also adhere to laws regarding employment for individuals with arrest or conviction records.