Location: Strongly prefer West Coast candidate to reside within 50 miles of an Elevance Health office, and able to commute on-site at least 3 days per week.
Introduction:
Carelon Health is a part of the Carelon family of companies. As a payer-agnostic, subsidiary of Elevance Health, Carelon brings together the company's healthcare services brands and 40,000-plus associates to help solve complex challenges across the health ecosystem. Through our portfolio of businesses, the Carelon family of companies serves one in three people across all 50 states.
Summary:
We seek a Staff VP of Network Contracting for this exciting opportunity to drive change and impact care delivery with provider partners. In this role, you will provide leadership, guidance, and oversight with respect to Value-Based Contracting with providers. You will oversee all provider network functions, including provider service, strategic relationships, and the value-based contracting strategy for the organization. The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, matrixed environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders and stakeholders.
Team Scope:
As Staff VP of Network Contracting, you will be responsible for a team of 10 FTE's.
Primary duties may include, but are not limited to:
Develops and implements network contracting and network expansion strategies specific to enterprise contracts, to include identifying and cultivating strategic alliances and building new network models with significant provider organizations.
Provides strategic design and implementation of high-performance networks to include facility and provider performance incentives.
Delivers planned medical trends and high quality/large provider networks that support business objectives for Medical Loss Ratio (MLR), growth, and income results.
Requires collaborating to identify customers' needs and to close network gaps.
Assists staff, as needed, during contract negotiations with high-volume provider groups or facilities.
Chairs and/or participates on internal committees, joint operating committees with provider organizations (providers) and operations meeting.
Ensures compliance with all regulatory and accreditation standards.
Oversees provider services to include provider education and general provider relations support.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Qualifications:
Requires a BA/BS degree; or any combination of education and experience, which would provide an equivalent background. Minimum of 10 years progressively responsible related experience in contract negotiation, network development and provider relations strongly preferred.
Preferred Skills, Capabilities and Experiences
10+ years of experience in contract negotiation, network development and provider relations
Comprehensive understanding of value-based strategies and population health management
Strong experience building and maintaining relationships with large hospitals/provider systems, integrated delivery systems, and large physician groups
Strong leadership skills
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $170,400.00 to $306,720.00.
Locations: California and Nevada
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.
