Elevance Health
Provider Network Management Director
Elevance Health, Los Angeles, California, United States, 90079
Provider Network Management Director
Anticipated End Date:
2025-11-03
Location:
California. This role requires associates to be in office 3 days per week, fostering collaboration and connectivity, while providing flexibility. Alternate locations may be considered. Travel to worksite and other locations as necessary.
Job Description:
The Provider Network Management Director is responsible for developing and managing the provider network through strategic contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups, including employed, hospital-based, and hospital-owned ancillary providers. Primary focus is contracting and negotiating complex terms with the most intricate health systems and affiliated providers, supporting value‑based initiatives. Extensive experience across Medicare, Medicaid, and commercial lines; understanding of claims, pricing, and system configuration. Must have contracting and negotiation experience involving $25 million or more, executive presentation experience, high-level coordination, and executive leadership engagement.
How you will make an impact
Serve in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
Serve as a subject‑matter expert for local contracting efforts or highly specialized components of the contracting process and represent a business unit.
Lead large‑scale, multi‑faceted negotiations.
Represent the business unit on enterprise initiatives around network management and lead projects with significant impact.
Assist management in network development planning.
Provide work direction, establish priorities for field staff, mentor associates.
Negotiate non‑standard arrangements requiring high skill level.
Customize fee schedules.
Work independently with high judgment and discretion.
Collaborate with sales team in making presentations to employer groups.
Serve as communication link between providers and the company.
Conduct the most complex negotiations.
Prepare financial projections and conduct analysis.
Minimum Requirements BA/BS degree and a minimum of eight (8) years’ experience in contracting (value‑based, shared savings, ACO development), provider relations, provider servicing. Prior contracting experience required.
Preferred Skills, Capabilities, and Experience
Experience in healthcare contracting, with direct skill in negotiating with large providers and service vendors.
Track record of negotiating and managing provider contracts, understanding industry standards, billing codes, reimbursement mechanisms, regulatory landscape.
Deep knowledge of Medicare, Medicaid, and commercial business practices.
Ability to negotiate complex contracts with payers, securing favorable terms.
Experience using financial models and analysis to negotiate rates.
Exceptional strategic thinking, decision‑making, problem‑solving, adaptability.
Confidence interacting with senior management and executive stakeholders; influence decision‑making.
Excellent written, oral, presentation, and interpersonal communication skills; proven ability to negotiate expectations between parties.
Proficiency with Microsoft Office (Excel, Teams, Outlook, PowerPoint, Word).
Salary $116,380 to $182,160.
Job Level Director Equivalent.
Workshift 1st Shift (United States).
Job Family PND > Network Contracting.
Equal Employment Opportunity Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to protected status. Qualified applicants with arrest or conviction records will be considered in accordance with federal, state, and local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
#J-18808-Ljbffr
2025-11-03
Location:
California. This role requires associates to be in office 3 days per week, fostering collaboration and connectivity, while providing flexibility. Alternate locations may be considered. Travel to worksite and other locations as necessary.
Job Description:
The Provider Network Management Director is responsible for developing and managing the provider network through strategic contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups, including employed, hospital-based, and hospital-owned ancillary providers. Primary focus is contracting and negotiating complex terms with the most intricate health systems and affiliated providers, supporting value‑based initiatives. Extensive experience across Medicare, Medicaid, and commercial lines; understanding of claims, pricing, and system configuration. Must have contracting and negotiation experience involving $25 million or more, executive presentation experience, high-level coordination, and executive leadership engagement.
How you will make an impact
Serve in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
Serve as a subject‑matter expert for local contracting efforts or highly specialized components of the contracting process and represent a business unit.
Lead large‑scale, multi‑faceted negotiations.
Represent the business unit on enterprise initiatives around network management and lead projects with significant impact.
Assist management in network development planning.
Provide work direction, establish priorities for field staff, mentor associates.
Negotiate non‑standard arrangements requiring high skill level.
Customize fee schedules.
Work independently with high judgment and discretion.
Collaborate with sales team in making presentations to employer groups.
Serve as communication link between providers and the company.
Conduct the most complex negotiations.
Prepare financial projections and conduct analysis.
Minimum Requirements BA/BS degree and a minimum of eight (8) years’ experience in contracting (value‑based, shared savings, ACO development), provider relations, provider servicing. Prior contracting experience required.
Preferred Skills, Capabilities, and Experience
Experience in healthcare contracting, with direct skill in negotiating with large providers and service vendors.
Track record of negotiating and managing provider contracts, understanding industry standards, billing codes, reimbursement mechanisms, regulatory landscape.
Deep knowledge of Medicare, Medicaid, and commercial business practices.
Ability to negotiate complex contracts with payers, securing favorable terms.
Experience using financial models and analysis to negotiate rates.
Exceptional strategic thinking, decision‑making, problem‑solving, adaptability.
Confidence interacting with senior management and executive stakeholders; influence decision‑making.
Excellent written, oral, presentation, and interpersonal communication skills; proven ability to negotiate expectations between parties.
Proficiency with Microsoft Office (Excel, Teams, Outlook, PowerPoint, Word).
Salary $116,380 to $182,160.
Job Level Director Equivalent.
Workshift 1st Shift (United States).
Job Family PND > Network Contracting.
Equal Employment Opportunity Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to protected status. Qualified applicants with arrest or conviction records will be considered in accordance with federal, state, and local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
#J-18808-Ljbffr