Provider Network Management Director

Location: This position will work a hybrid model (remote and office). Must reside within 50 miles/1 hour commute of our Nashville, TN office.

The Provider Network Management Director develops the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed and hospital based and hospital owned ancillary providers. Primary focus of this role is contracting and negotiating contract terms, dealing with only the most complex health systems and affiliated providers, and driving and supporting value-based initiatives.

How you will make an impact:

1. Serve in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
2. Act as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process.
3. Typically serve as lead contractor for large scale, multi-faceted negotiations.
4. Represent the business unit on enterprise initiatives around network management and lead projects with significant impact.
5. Assist management in network development planning.
6. Provide work direction and establish priorities for field staff; involved in associate development and mentoring.
7. Handle contracts involving non-standard arrangements that require a high level of negotiation skills.
8. Work independently, requiring high level of judgment and discretion.
9. Collaborate with other key areas or serve on enterprise projects around network management.
10. Collaborate with sales team in making presentations to employer groups.
11. Serve as a communication link between providers and the company.
12. Conduct the most complex negotiations.
13. Prepare financial projections and conduct analysis.

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; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Experience using financial models and analysis to negotiate rates with providers strongly preferred.
• Provider network build with demonstrated success in implementing recruiting plans and network adequacy experience strongly preferred.
• Commercial line of business contracting experience along with Tennessee provider landscape knowledge strongly preferred.

Travels to worksite and other locations as necessary.

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 for assistance.