Director Network Management- Carelon Behavioral Health
Elevance Health
**Director Network Management- Carelon Behavioral Health**
Location: Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles of our Richmond or Ashburn, Virginia Elevance Health PulsePoint locations.
Reporting to the RVP of Provider Networks in the East for Carelon Behavioral Health, this **Director of Network Management** oversees the recruitment and negotiation of providers joining our BH network, as well as the provider relations team responsible for provider education, and engagement resolving claims, authorization, and utilization concerns for the states of Virginia and Ohio. This Director will lead a team of network managers and provider relation account managers responsible for network development and provider reimbursement for Virginia and Ohio.
**How you will make an impact:**
+ Oversees contracting and maintenance of all facilities including hospitals, surgery centers, etc.
+ Oversees the development, maintenance and reconciliation of physician risk contracts and capitated arrangement.
+ Attracts, develops and manages key contracting and servicing staff.
+ Develops innovative ways to maintain a cost-effective network with adequate access and positive working relationships with providers.
+ Hires, trains, coaches, counsels, and evaluates performance of direct reports.
**Minimum Requirements:**
+ Requires a BS/BA degree in business administration or related healthcare field and a minimum of 8 years healthcare operations, finance, underwriting, actuary, network development and sales experience; or any combination of education and experience, which would provide an equivalent background.
**Preferred Qualifications:**
+ CPA or MBA degree.
+ Network development, network management, and provider relations experience in the behavioral healthcare provider domain.
+ Proven career experience leading large strategic projects and programs across a matrix enterprise.
+ Lean 6 Sigma discipline and training.
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 and Influenza. 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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