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Elevance Health · 5 hours ago

Provider Network Manager (US)

Latham, NY

Full-time

Hybrid

Mid Level

$69K/yr - $86K/yr

3+ years exp

Elevance Health is a health company dedicated to improving lives and communities. The Provider Network Manager is responsible for developing the provider network through contract negotiations, relationship development, and servicing, with a primary focus on contracting and negotiating contract terms.

Health CareHealth InsurancePersonal HealthWellness

Responsibilities

Develops the provider network through contract negotiations (language and rates), relationship development, and servicing

Primary focus of this role is contracting and negotiating contract terms

Typically works with less-complex to complex providers

Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required

Contracts may involve non-standard arrangements that require a moderate level of negotiation skills

Fee schedules can be customized

Works with increased independence and requires increased use of judgment and discretion

May work on cross-functional projects requiring collaboration with other key areas

Serves as a communication link between professional providers and the company

Conducts more complex negotiations and drafts documents

Assists in preparing financial projections and conducting analysis as required

Qualification

Contract negotiationProvider relationsProvider servicingProvider billingCodingSingle Case Agreement

Required

a BA/BS degree and a minimum of 3 years' experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background

Travels to worksite and other locations as necessary