Provider Network Manager Sr

Position Title

Provider Network Manager Sr

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

Standard Working hours

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.

Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required.

Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized.

• Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development
• 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 professional providers and the company
• Ensure that network composition includes an appropriate distribution of provider specialties
• Conducts more complex negotiations and drafts documents
• Prepare financial projections and conduct analysis

• Requires a BA/BS degree and a minimum of 5 years’ experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which 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

Non-Management Exempt

1st Shift (United States of America)

PND >
Network Contracting

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 required to work at an Elevance Health location at least once per…