Provider Network Management Director
Anthem Blue Cross & Blue Shield
Position Title:Provider Network Management Director
Provider Network Management Director
The Provider Network Management Director develops strategies for provider networks leveraging contract negotiations, local relationships, value-based and care enablement, product development, and digital solutions with large health systems and affiliated physician groups including employed and hospital-based and hospital-owned ancillary providers, among others. Collaborates with local contracting teams and leads to drive deals with complex health systems, affiliated providers and supports value-based and cost of care initiatives to meet financial targets and meet market needs for Commercial Business segments including Individual.
How you will make an impact:
- Serves in a leadership capacity and advisor to market teams, leading network strategy for assigned commercial markets and segments.
- Collaborates with development team to translate strategy into defined tactics, programs/projects priorities, and timelines and ensures alignment and attainment of enterprise strategic plans to turn strategy into reality.
- Serves as a subject matter expert for prioritized strategic activities across multiple markets and serves as subject matter expert for Commercial and Individual business for local network teams. Documents strategic priorities such as external environment, partner landscape, cost of care drivers and reports on customer insight research initiatives as needed.
- Partners with lead contractors for large-scale, multi-faceted negotiations to provide data, insight and expertise on strategic options.
- Serves as business unit representative on enterprise initiatives around network strategy in assigned markets and leads projects with significant impact.
- Assists management in multi-year strategy 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 strategies for assigned markets.
- Partners with local contracting teams to manage to outcomes on the most complex negotiations.
- Works with analytics teams to understand market targets, develop expected vs actual financial projections for target markets, and may conduct analysis to support provider discussions.
- Cross-functional collaboration including supporting sales team in presentations to local employer groups.
- 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.
- 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 $97,680 to $184,615.
Locations: California; Colorado; Nevada; New York, Washington State; Jersey City, NJ
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.
Job Level:Director Equivalent
Job Family:PND > Network Contracting
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and 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 – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.