Senior Provider Network Manager

4 weeks ago


New Hyde Park, New York, United States Elevance Health Full time
Job Summary

We are seeking a skilled Senior Provider Network Manager to join our team at Elevance Health. In this role, you will be responsible for developing and maintaining our provider network through contract negotiations, relationship development, and servicing. Your primary focus will be on contracting and negotiating contract terms with complex providers, including large medical groups, institutional providers, and ancillary providers.

Key Responsibilities

* Conducts complex negotiations and drafts documents
* Prepares financial projections and conducts analysis
* Serves as a key resource for other contracting staff and provides mentoring and on-the-job training and development
* Works independently and requires critical thinking, and a high level of judgment and discretion

Requirements

* Requires a BA/BS degree and a minimum of 5 years' experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
* Experience in fee schedule development using actuarial models strongly preferred
* Experience in contract language negotiations strongly preferred
* Medicare, Medicaid and Commercial reimbursement methodologies knowledge strongly preferred

What We Offer

* A comprehensive benefits package
* Incentive and recognition programs
* Equity stock purchase and 401(k) contribution

Location

This role is based in New York and requires travel to worksite and other locations as necessary. 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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