Provider Contract Consultant

Provider Contract Consultant

Anticipated End Date:

Position Title:

Provider Contract Consultant

Job Description:

Provider Contract Consultant

This role requires associates to be in-office 1 - 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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.

• Creates common contract templates for various provider groups to be used throughout the enterprise.
• Works closely with Legal and provider contracting management to ensure that contracts meet all federal, state and regulatory requirements.
• Recommends language changes and use of alternative or exception language approved for specific uses.
• Reviews contract language in response to RFPs, audits, and legal clarifications.
• Makes recommendations to contract modifications and presents to governing committee for approval.
• Works with contract negotiators to identify areas where push-back is appropriate and helps to educate contract negotiators on contract language impacts.
• Review contracts to ensure that contract terms and language can be implemented appropriately.
• Researches and quantifies impact to contract modifications.
• Maintains tracking software to assist in reporting and responding to key leadership, providers, and consumers.
• Develops tools to assist contract negotiators in negotiating effective contracts.

• Requires a BA/BS degree in a related field and a minimum of 3 years related experience with contract language, contract development, negotiation, and/or administration; or any combination of education and experience, which would provide an equivalent background.

Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America)
Job Family: PND >
Network Contracting

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

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.

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…