Provider Contract Specialist Manager

Position Title : Provider Contract Specialist Manager

Job Description :

The Provider Contract Specialist Manager functions with expertise in managing negotiated pricing loads. Responsible for coordinating the process for the most complex pricing arrangements involving facilities or large health systems, or high-profile provider groups and / or physician groups tied to large hospital systems joining the network, including creating standard contracts for providers as needed.

How you will make an impact :

• Manage provider update files submitted by delegated provider entities and / or large groups / integrated delivery system.
• Prepare the information for timely and accurate submission to the Provider Data Management area.
• Ensure updates / changes for existing network providers are interpreted and loaded accurately.
• Ensure accurate and timely loading of professional and facility contracts across value-based and fee-for-service agreements for provider solutions.
• Works directly with contracting directors and managers to understand what is negotiated and how the negotiated agreement is translated into the company's systems resulting in accurate and timely loading.
• Performs internal audit of provider record, ensuring accuracy against rosters.
• Serves as the go-to with matrix partners to resolve interpretation issues and ensure timely turnaround.
• Serve as local market expert supporting (and managing when necessary) the provider onboarding process and provider updates submitted by provider offices within defined market.
• Must possess critical thinking skills, have a proven strong eye for detail and a focus on quality.

Minimum Requirements :

Preferred Skills, Capabilities and Experiences :

Work Environment :

Hybrid 1 : This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.

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.

J-18808-Ljbffr