• Provider Network Manager

    Elevance HealthCumming, IA 50061

    Job #2692485615

  • Location: Des Moines, Iowa

    Hours: Standard M - F

    Travel: Hybrid role (1-2 days per week in office)

    Position Overview:

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

    How You Will Make an Impact:

    • 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, Value based concepts understanding, 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

    Required Qualifications:

    • Requires 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.

    Preferred Qualifications:

    • Medicaid or Medicare experience strongly preferred

    • Previous Healthcare Contract negotiation experience strongly preferred

    • Knowledge of Iowa Medicaid fee schedules preferred

    • Strong communications experience preferred