Provider Network Manager

Company: Elevance Health
Location: Sacramento
Posted on: May 3, 2025

Job Description:

Location: Sacramento CAHours: Monday - FridayTravel: Hybrid (1-2 days onsite per week)Position Overview:Develops the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms.How You Will Make an Impact:

• 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:
    • Willing to travel to various worksites and other locations to support business needs.
    • Experience negotiating on behalf of Health plan or Healthcare system is a must.
    • Experience with Medicaid, Medicare, and commercial plans strongly preferred.
    • Intermediate Microsoft Excel experience preferred.
    • Claims experience is a nice to have.
    • Strong expertise in MS Access, OneNote, Excel, and PowerPoint is a must.For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $72,336 to $108,504.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 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 and Influenza. 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.
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Keywords: Elevance Health, Carmichael , Provider Network Manager, Executive , Sacramento, California