Provider Network Manager Sr

Elevance Health • Grand Prairie, TX

2d • Hybrid

About The Position

JR183772 Provider Network Manager Sr The Provider Network Manager Sr develops the provider network through contract negotiations, relationship development, and servicing. Location: Hybrid 1: This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. How will you make an impact: Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development. Works independently and requires high level of judgment and discretion. 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. Serves as a communication link between professional providers and the company. Ensure that network composition includes an appropriate distribution of provider specialties. Conducts more complex negotiations and drafts documents. Prepare financial projections and conduct analysis.

Requirements

• Requires 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.

Nice To Haves

• Strong provider and facility contracting experience is critical for success in this role, including complex negotiations, rate development, reimbursement modeling, and contract execution within highly regulated environments.
• Texas Medicaid managed care experience highly preferred, including familiarity with HHSC requirements, waiver programs, and state-specific compliance standards.
• Experience contracting with behavioral health providers strongly preferred.
• Extensive Managed Care Organization (MCO) and/or Texas health plan experience, including understanding of network adequacy, value-based arrangements, performance metrics, and quality standards.
• Ability to collaborate cross-functionally with clinical, operations, compliance, and sales teams to support network growth and market strategy.

Responsibilities

• Serves as key resource for other contracting staff and provides mentoring and on-the-job training and development.
• Works independently and requires high level of judgment and discretion.
• 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.
• Serves as a communication link between professional providers and the company.
• Ensure that network composition includes an appropriate distribution of provider specialties.
• Conducts more complex negotiations and drafts documents.
• Prepare financial projections and conduct analysis.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level