Shire Jobs

Provider Network Management Director

Location: This position will work a hybrid model (remote and office). Must reside within 50 miles/1 hour commute of an Elevance Health location.

The Provider Network Management Director develops the provider network by managing the implementation of strategies for provider recruitment, contract negotiations, and relationship development for large health systems and affiliated physician groups including employed and hospital based and hospital owned ancillary providers, among others, for Commercial Business segments including Individual. Primary focus of this role is developing the network and ensuring state and federal regulatory requirements are met by the constructed network. Works 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.

How you will make an impact:

• Serves in a leadership capacity and advisor to market teams, leading associate resources, special projects/initiatives, and/or network planning.

• Serves as a subject matter expert for prioritized contracting efforts across multiple markets or in highly specialized components of the contracting process and serves as subject matter expert for Commercial and Individual business for local network teams. Partners with lead contractors for large scale, multi-faceted negotiations to provide data, insight and expertise.

• Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.

• 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.

• May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.

• May collaborate with sales team in making presentations to employer groups.

• Works with Team of Team leads to serve as a communication link between providers and the company by lending expertise on network development efforts. Partners with local contracting teams to manage to outcomes on the most complex negotiations.

• May work with analytics teams to prepare financial projections and conducts analysis to support provider discussions.

Minimum Qualifications:

• Requires a 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; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experience:

• Experience using financial models and analysis to negotiate rates with providers strongly preferred.

• Project management experience.

• Health plan network development experience.

• Ability to work independently with a high level of judgment and discretion.

• May require travel up to 30%.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $98,000 to $183,750.

Locations: California; Colorado; District of Columbia (aka Washington, DC); Maryland, Nevada; New York; Washington State

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, nondiscriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.