Provider Network Manager Sr

Location: Atlanta GA, Tampa FL, Richmond VA, Columbus GA, Norfolk VA, Durham NC

Hours: Standard Working hours

Travel: This role requires associates to be in office 1-2 days per week, fostering collaboration while allowing flexibility. Alternate locations may be considered if candidates reside within commuting distance from an office.

Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus is contracting and negotiating contract terms with the most complex providers, including large institutional providers, large medical groups, ancillary providers, and value‑based concepts.

• Serves as key resource for other contracting staff and provides mentoring and on‑the‑job training and development.
• Works independently with a high level of judgment and discretion.
• May work on projects impacting the business unit and collaborate 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 professional providers and the company.
• Ensures that network composition includes an appropriate distribution of provider specialties.
• Conducts more complex negotiations and drafts documents.
• Prepares financial projections and conducts analysis.

• Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, and provider servicing. Experience should include prior contracting experience; or any combination of education and experience that would provide an equivalent background.

• Commercial health plan experience strongly preferred.
• Experience negotiating capitated agreements.
• Experience negotiating large, complex health systems with various provider types such as ancillary, facility, physician.
• Experience in fee schedule development using actuarial models strongly preferred.
• Experience working in a fast‑paced environment with critical deadlines.
• Data analysis experience preferred.
• Travels to worksite and other locations as necessary. Equal Employment Opportunity

  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.
  
  Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.