Provider Network Manager Sr

This is an Individual Contributor role enabling associates to work virtually full-time, except for required in-person training sessions. Candidates must reside within a reasonable commuting distance from an office location or be granted accommodation as required by law.

About the role

A proud member of the Elevance Health family of companies, Carelon Behavioral Health uses our powerful combination of experience, expertise, dedication, and compassion to see what's possible and what's better. Born out of one of the largest healthcare systems in the United States, our rich history gives us a unique and valuable perspective on how to solve the most pressing healthcare challenges.

Schedule

Monday – Friday, 40 hours per week, either 8:00 am to 5:00 pm or 9:00 am to 6:00 pm.

Responsibilities

• Develop the provider network through contract negotiations, relationship development, and servicing, with a primary focus on contracting and negotiating contract terms.
• Work with the most complex providers, including large institutional providers, large medical groups, ancillary providers, value-based concepts, and providers in highly competitive or education-intensive areas.
• Handle non-standard contract arrangements requiring high-level negotiation skills and customized fee schedules.
• Serve as a key resource for other contracting staff, providing mentoring and on-the-job training.
• Work independently with a high level of judgment and discretion.
• Collaborate on projects impacting the business unit or serve on enterprise projects related to network management.
• Act as a communication link between professional providers and the company.
• Ensure network composition includes an appropriate distribution of provider specialties.
• Conduct complex negotiations and draft documents.
• Prepare financial projections and conduct analysis.
• Travel to worksites and other locations as necessary.

Requirements

• BA/BS degree and a minimum of 5 years of experience in contracting, provider relations, or provider servicing, including prior contracting experience; or any combination of education and experience providing an equivalent background.

Skills

• Experience in fee schedule development using actuarial models (strongly preferred).
• Strong project management skills.
• Comprehensive negotiation skills supporting multi-service lines of business.

Pay

For candidates working in person or virtually in Colorado or Nevada, the salary range for this position is $91,812 to $144,276. The salary offered is based on legitimate, non-discriminatory factors such as geographic location, work experience, education, and skill level.

Benefits

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