Provider Network Manager Sr - Maryland
Elevance Health

Job Info

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A proud member of the Elevance Health family of companies, Carelon Behavioral Health, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Provider Network Manager Sr - Maryland

*Candidates must live in the state of Maryland.

This position will work a Hybrid Model (remote and office). Ideal candidates Must live within 50 miles or a 1 hour commute to the Maryland Elevance Health corporate office. Travels to worksites and other locations as necessary.

Work Shift: Monday through Friday, 8 am to 5 pm (EST).

The Provider Network Manager Sr develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with the most complex providers. Complex providers may include, but are not limited to large institutional providers, large medical groups and ancillary providers, value based concepts understanding and support, providers in areas with strong competition or where greater provider education around managed care concepts is required. Contracts involve non-standard arrangements that require a high level of negotiation skills. Fee schedules are customized.

How you will make an impact:

• Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
  
• Works independently and requires high level of judgment and discretion.
  
• 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.
  
• Serves as a communication link between professional providers and the company.
  
• Ensures that network composition includes an appropriate distribution of provider specialties.
  
• Conducts more complex negotiations and drafts documents.
  
• Prepares financial projections and conducts analysis.
  

Minimum Requirements:

• Requires a BA/BS degree and a minimum of 5 years' experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
  

Preferred Skills, Capabilities and Experiences:

• Experience in fee schedule development using actuarial models strongly preferred.
  

For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $90,300 to $135,450

Location: Maryland

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, non-discriminatory 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.

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