Hybrid Provider Network Management Director – Medicare Network Build

at Elevance Health

• Job title: Provider Network Management Director – Medicare Network Build
• Job type: Full Time
• Experience level: Lead
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Little Rock, United States

About the role

• Provider Network Management Director develops provider networks for Medicare in Arkansas through contract negotiations and relationship management with health systems. Leading complex negotiations and serving as a subject matter expert in the field.

Responsibilities

• develops the provider network in Arkansas through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups
• contracting and negotiating contract terms for Medicare, Medicaid, and ACA programs
• serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning
• serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process
• typically serves as lead contractor for large scale, multi-faceted negotiations
• conducts the most complex negotiations
• prepares financial projections and conducts analysis

Requirements

• Requires a BA/BS degree
• minimum of 8 years’ experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing
• experience must include prior contracting experience
• Medicare network contracting/reimbursement methodology strongly preferred
• Medicaid and Commercial network contracting preferred
• experience building networks with integrated delivery health systems strongly preferred
• knowledge of Value-Based Contracts preferred
• Contraxx, Facets, SPS preferred
• experience using financial models and analysis to negotiate rates with providers strongly preferred

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) + match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources