Provider Network Management Director

1 week ago


Wilmington, Delaware, United States Elevance Health Full time
Job Title: Provider Network Management Director

Job Summary:

The Provider Network Management Director is responsible for developing and implementing strategies for provider recruitment, contract negotiations, and relationship development for large health systems and affiliated physician groups. This role requires a strong understanding of healthcare regulations and a ability to work collaboratively with local contracting teams and leads to drive deals with complex health systems, affiliated providers, and supports value-based and cost-of-care initiatives.

Key Responsibilities:

  • Develop and implement provider network strategies to meet state and federal regulatory requirements
  • Manage provider recruitment and contract negotiations with large health systems and affiliated physician groups
  • Develop and maintain relationships with key stakeholders, including health system leaders, physicians, and other healthcare professionals
  • Collaborate with local contracting teams and leads to drive deals with complex health systems, affiliated providers, and supports value-based and cost-of-care initiatives
  • Provide data, insight, and expertise to support prioritized contracting efforts across multiple markets or in highly specialized components of the contracting process
  • Partner with lead contractors for large-scale, multi-faceted negotiations
  • Serve as a subject matter expert for prioritized contracting efforts across multiple markets or in highly specialized components of the contracting process
  • 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

Requirements:

  • BA/BS degree and a minimum of 8 years' experience in contracting (value-based, shared savings, and ACO development), provider relations, provider servicing, health plan network implementations
  • Experience must include prior contracting experience
  • Strong understanding of healthcare regulations and ability to work collaboratively with local contracting teams and leads
  • Ability to work independently with a high level of judgment and discretion
  • May require travel up to 30%

Preferred Skills, Capabilities, and Experience:

  • Experience using financial models and analysis to negotiate rates with providers
  • Project management experience
  • Health plan network development experience

Salary and Benefits:

The salary range for this position is $98,000 to $183,750. Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution.

Location:

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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