Elevance Health
Location
Palo Alto, CA | United States
Job description
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.
Dir Network Management - CA
Job Family: PND > Provider Relationship Account Mgmt
Type: Full time
Date Posted:Feb 20, 2024
Anticipated End Date:Mar 20, 2024
Reference: JR105553
Location:
CA, CERRITOS
California, Woodland Hills
California, Los Angeles
California, Sacramento
California
Description
Carelon Behavioral Health, Inc. is enthusiastically supporting the launch of the Statewide School-Based Fee Schedule project by the Department of Health Care Services (DHCS) as the dedicated Third-Party Administrator. Our goal? To improve the mental health services offered to California's young students via this pivotal initiative.
We're expanding our team and eager to connect with professionals experienced in healthcare administration, network management, provider credentialing, data analysis, and claims processing. You'll play an essential role in managing claims payments and remittances, overseeing our provider network, credentialing providers, undertaking data exchanges, and maintaining quality oversight.
With this project, we're aligning our goals with Governor Newsom's Kids’ Mental Health and the Children and Youth Behavioral Health Initiative (CYBHI). We're working closely with DHCS, the Department of Managed Health Care (DMHC), and the California Department of Insurance (CDI) to implement a multi-payer fee schedule, ensuring fair reimbursement for school-linked providers offering designated outpatient mental health and substance use disorder services.
Director Network Management - CALIFORNIA
Location: This position will work a Hybrid model (remote and office). Ideal candidates will live in the state of California within 50 miles from one of our Elevance Health corporate offices. This position will travel to worksite and other locations as necessary.
* Seeking candidates that reside in the state of California.
Work Shift: Monday thru Friday, 5 days a week during Pacific Standard Time business hours.
The Director Network Management is responsible for network development, recruitment, provider reimbursement, provider relations, provider education and communication for the statewide school based TPA.
How you will make an impact:
Sets and develops the network strategy and day to day operations of the TPA program.
Oversees contracting and maintenance of all school based counseling resources.
Oversees the development, maintenance and reconciliation of provider contracts.
Oversees all provider relations and engagement functions to support the TPA.
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:
Preferred Skills, Capabilities and Experiences:
MBA degree.
People management/people leadership experience.
Project management experience highly preferred.
Strongly prefer work experience in education or a school system.
Experience with California Medi-Cal.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $140,196 to $240,336.
Locations: California
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
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 [email protected] for assistance.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
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EEO Policy Statement
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Pay Transparency
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