Provider Network Manager

4 weeks ago


Iowa, United States Elevance Health Full time

Location:

Des Moines, Iowa Hours:

Standard M – F Travel:

Hybrid role (1-2 days per week in office)

Position Overview: Develops the provider network through contract negotiations (language and rates), relationship development, and servicing. How You Will Make an Impact: 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

Required Qualifications: 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.

Preferred Qualifications: Medicaid or Medicare experience strongly preferred

Previous Healthcare Contract negotiation experience strongly preferred

Knowledge of Iowa Medicaid fee schedules preferred

Strong communications experience preferred

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