Network Management Director

5 days ago


Greenville, South Carolina, United States Elevance Health Full time
Job Title: Director Network Management-South Carolina

Job Summary:

The Director Network Management is responsible for developing and implementing network contracting and expansion strategies, including identifying and cultivating strategic alliances and building new network models with significant provider organizations. This role oversees the design and implementation of high-performance networks, including facility and provider performance incentives, and is responsible for contracting and maintaining all facilities, including hospitals and surgery centers. Additionally, this position oversees the development, maintenance, and reconciliation of physician risk contracts and capitated arrangements. The Director will also assist staff during contract negotiations with high-volume provider groups or facilities and develop innovative ways to maintain a cost-effective network with adequate access and positive working relationships with providers.

Key Responsibilities:
  • Develops and implements network contracting and expansion strategies.
  • Oversees the design and implementation of high-performance networks.
  • Contracts and maintains all facilities, including hospitals and surgery centers.
  • Oversees the development, maintenance, and reconciliation of physician risk contracts and capitated arrangements.
  • Assists staff during contract negotiations with high-volume provider groups or facilities.
  • Develops innovative ways to maintain a cost-effective network with adequate access and positive working relationships with providers.

Requirements:
  • Requires a BS/BA degree in business administration or a related healthcare field and a minimum of 8 years of healthcare operations, finance, underwriting, actuary, network development, and sales experience.

Preferred Skills:
  • Strongly preferred CPA or MBA degree.
  • Strong experience in contract negotiation, network development, and provider relations.
  • Value-Based program experience strongly preferred.
  • Proven leadership experience with the ability to coach, develop, and engage strong teams.

About Elevance Health:

Elevance Health is a health company dedicated to improving lives and communities. 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.

Our Culture:

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We also offer medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.

Work Environment:

Elevance Health operates in a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

Equal Employment Opportunity:

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.

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