Provider Network Manager

Provider Network Manager

Hybrid 1:
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.

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

The Provider Network Manager is responsible for developing the provider network through contract negotiations (language and rates), relationship development, and servicing.

• Primary focus of this role is contracting and negotiating contract terms.
• Typically works with less-complex to complex providers. Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required.
• Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. Value based concepts understanding.
• Fee schedules can be customized.
• Works with increased independence and requires increased use of judgment and discretion.
• May work on cross-functional projects requiring collaboration with other key areas.
• Serves as a communication link between professional providers and the company.
• Conducts more complex negotiations and drafts documents.
• Assists in preparing financial projections and conducting analysis as required.

• Requires a BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background. Travels to worksite and other locations as necessary.

• Strong contracting background and negotiation skills preferred.
• Familiarity with all lines of business.

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, and 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.