Provider Network Management Director

This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

About the role

The Provider Network Management Director is responsible for developing the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed and hospital-based and hospital-owned ancillary providers.

Responsibilities

• Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
• Acts as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process for a business unit.
• Leads large-scale, multi-faceted negotiations as the primary contractor.
• Represents the business unit on enterprise initiatives around network management and leads high-impact projects.
• Assists management in network development planning and may provide work direction or establish priorities for field staff, including associate development and mentoring.
• Handles non-standard contract arrangements requiring advanced negotiation skills and customized fee schedules.
• Works independently with a high level of judgment and discretion.
• Collaborates on projects impacting the business unit or enterprise-wide network management.
• Partners with the sales team to make presentations to employer groups.
• Serves as a communication link between providers and the company.
• Conducts the most complex negotiations and prepares financial projections and analysis.
• Travels to worksite and other locations as necessary.

Requirements

• BA/BS degree and a minimum of 8 years' experience in contracting (value-based, shared savings, and ACO development), provider relations, or provider servicing, including prior contracting experience; or any combination of education and experience providing an equivalent background.

Preferred Qualifications

• 5+ years' experience supporting hospital systems.
• Experience using financial models and analysis to negotiate rates with providers.
• Extensive experience providing enterprise-wide support across all lines of business: Commercial, Medicaid, and Medicare.
• High-impact provider negotiation experience.

Pay

For candidates working in person or virtually in California, Nevada, and Washington State, the salary range for this specific position is $108,276.00–$185,616.00. The salary offered is based on legitimate, non-discriminatory factors such as geographic location, work experience, education, and skill level. The Company is committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other protected category.

Benefits

• Comprehensive benefits package (medical, dental, vision, short and long-term disability).
• Incentive and recognition programs.
• 401(k) contribution with company match.
• Equity stock purchase plan.
• Paid holidays and Paid Time Off (PTO).
• Life insurance.
• Wellness programs and financial education resources.

Schedule

Elevance Health operates in a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week, with specific onsite expectations discussed during the hiring process.