Provider Network Manager Sr

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 and connectivity, while providing flexibility to support productivity and work‑life balance. 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—large institutional providers, large medical groups, ancillary providers, and providers in highly competitive markets or where additional 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.
• 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, provider servicing; prior contracting experience is expected. Any combination of education and experience that provides an equivalent background is acceptable.

• 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.
• Travel to worksite and other locations as necessary.

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.