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Provider Network Management Director
2 months ago
Job Title: Provider Network Management Director - California
Location: This position will work a hybrid model (remote and office). Must reside within 50 miles/1 hour commute from Elevance Health locations.
Job Summary:
- Develops the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups.
- Primary focus of this role is contracting and negotiating contract terms in the California market.
- Deals with only the most complex health systems, affiliated providers, and drives and supports value-based initiatives.
Key Responsibilities:
- Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
- Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as a subject matter expert for that area for a business unit.
- Typically serves as lead contractor for large-scale, multi-faceted negotiations.
- Serves as a business unit representative on enterprise initiatives around network management and leads projects with significant impact.
- May assist management in network development planning.
- May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
- Contracts involve non-standard arrangements that require a high level of negotiation skills.
- Fee schedules are customized.
- Works independently and requires a 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 teams in making presentations to employer groups.
- Serves as a communication link between providers and the company.
- Conducts the most complex negotiations.
- Prepares financial projections and conducts analysis.
Requirements:
- Requires a BA/BS degree and a minimum of 8 years' experience in contracting (value-based, shared savings, and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
- Exceptionally skilled in contract negotiations, financial acumen, problem-solving, and relationship management.
- Experience using financial models and analysis to negotiate rates with providers strongly preferred.
- California network/provider experience strongly preferred.
- Travels to worksite and other locations as necessary.
