Provider Network Management Director
Welcome to Elevance Health, a leading healthcare company dedicated to providing innovative solutions for our clients. We are currently seeking a highly motivated and experienced Provider Network Management Director to join our team. As the Director of Provider Network Management, you will play a critical role in building and maintaining strong relationships with our healthcare partners. Your expertise and leadership will be essential in driving the success of our provider network and ultimately improving the delivery of care for our members. If you are a strategic thinker with a passion for healthcare and possess the necessary qualifications, we would love to hear from you.
- Develop and implement strategies for building and maintaining a strong and effective provider network.
- Identify and evaluate potential healthcare partners, negotiate contracts, and maintain relationships with current providers.
- Ensure provider network meets company standards and contractual obligations.
- Continuously monitor and analyze network performance, identify areas for improvement, and implement necessary changes.
- Collaborate with other departments and teams to ensure alignment and coordination in provider network management.
- Stay updated on industry trends and changes in regulations related to provider networks, and incorporate necessary updates into network management strategies.
- Develop and maintain strong relationships with key stakeholders, including providers, hospitals, and other healthcare organizations.
- Oversee the credentialing and re-credentialing processes for providers in the network.
- Manage a team of provider network management professionals, providing guidance, support, and performance evaluations.
- Collaborate with other departments to ensure provider network management is aligned with overall company goals and objectives.
- Provide regular reports and updates on network performance to senior management.
- Serve as a liaison between the company and providers, addressing any concerns or issues that arise.
- Ensure compliance with all applicable laws, regulations, and company policies related to provider network management.
- Identify and implement innovative solutions to improve the delivery of care for members through the provider network.
- Foster a positive and collaborative work environment within the provider network management team.
Extensive Experience In Healthcare Operations And Management: The Ideal Candidate For The Provider Network Management Director Position At Elevance Health Should Have A Minimum Of 7-10 Years Of Experience In Healthcare Operations And Management, With A Focus On Provider Network Contracting, Credentialing, And Relationship Management.
Strong Negotiation And Analytical Skills: This Role Requires The Ability To Negotiate With Providers To Secure Competitive Rates And Contract Terms. The Candidate Should Possess Excellent Analytical Skills To Evaluate Provider Performance And Identify Areas For Improvement.
Knowledge Of Healthcare Regulations And Compliance: As A Provider Network Management Director, The Candidate Must Have A Thorough Understanding Of Healthcare Regulations And Compliance, Including Medicare And Medicaid Guidelines, Hipaa, And Other Relevant Laws And Regulations.
Demonstrated Leadership And Team Management Experience: The Candidate Should Have A Proven Track Record Of Leading And Managing A Team Successfully. They Should Be Able To Inspire And Motivate Team Members To Achieve Goals And Objectives Effectively.
Excellent Communication And Relationship-Building Skills: The Candidate Must Have Exceptional Communication Skills, Both Written And Verbal, To Effectively Communicate With Internal And External Stakeholders. They Should Also Be Able To Build And Maintain Positive Relationships With Providers, Network Partners, And Other Key Stakeholders.
Quality Improvement
Strategic Planning
Contract Management
Data Analysis
Negotiation
Relationship Building
network development
Credentialing
Cost Containment
Provider Relations
Provider Performance
Provider Contracting
Communication
Conflict Resolution
Emotional Intelligence
Leadership
Time management
creativity
Attention to detail
Teamwork
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a Provider Network Management Director in Indianapolis, IN, USA is $118,000 - $143,000 per year. This may vary depending on the specific company, experience level, and education of the individual.
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Elevance Health, Inc. is an American health insurance provider. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Empire BlueCross BlueShield in New York State, Anthem Blue Cross in California,Wellpoint, and Carelon.It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within their affiliated companies' health plans. Prior to June 2022, Elevance Health was named Anthem, Inc.
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