Location : IN-INDIANAPOLIS, 220 VIRGINIA AVE . Primarily work from home , Must report to the designated Pulse Point 1 time per week
Schedule: Monday- Friday, 8:00am-5:00pm EST.
Develops the provider network through contract negotiations, relationship development, and servicing.
Specifically focuses on developing and managing the provider network within the IN region through effective contract negotiations and relationship development.
Manages contract negotiations involving complex and non-standard arrangements for IN-based providers, including large institutional providers, expansive medical groups, and ancillary providers.
Drives the value-based contracting initiatives in IN, ensuring the provider network aligns with the competitive landscape and advancing managed care concepts.
Leads the contracting efforts to include customized fee schedules that cater to IN market requirements.
Acts as the primary point of contact for IN-specific provider networking and adjustments, based on regulatory changes and market dynamics.
Provides specialized training, guidance, and support for IN-specific contracting teams, focusing on the unique challenges and opportunities within this region.
Collaborates with IN Health Plan leadership to identify and address provider network gaps and ensure compliance with IN state regulations.
Prepares and delivers presentations on IN-specific network developments and strategic initiatives to internal stakeholders and employer groups.
Supports the integration efforts and transition plans for the IN market, coordinating closely with other departments and stakeholders.
Requirements:
a BA/BS degree and a minimum of 5 years' experience in contracting, provider relations, provider servicing; experience should include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
Experience in fee schedule development using actuarial models strongly preferred.
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 elevancehealthjobssupport@elevancehealth.com for assistance.
