Director Provider Solutions-New Jersey

Anticipated End Date:

2025-08-16

Position Title:

Director Provider Solutions-New Jersey

Job Description:

Director Provider Solutions-New Jersey

Location: New Jersey. This role requires associates to be in-office 3 days 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 an accommodation is granted as required by law.

The Director Provider Solutions is a dynamic and results-oriented leader committed to healthcare transformation through strategic leadership over all provider engagement and contracting activity in the New Jersey market. This role will oversee all lines of business and lead enterprise-wide initiatives to include local cost of care and trend management, innovative provider contracting, implementation of cutting-edge payment programs, and fostering robust provider relations and education.

How you will make an impact:

• Delivers competitive cost of care trends throughout New Jersey, positively impacting the affordability of respective health plan products.
• Develops new provider networks that establish a competitive advantage, optimizing respective provider relationships to most effectively benefit health plan growth priorities.
• Aligns contracting strategy with medical management strategy, integrating quality metrics and unique (non-traditional) incentives into the overarching contracting process, shepherding a market transition from “fee-based” reimbursement to a model based on quality achievement.
• Serves as PE&C local single point of accountability for all product lines and is the state lead for the Integrated Cost Management (ICM) committee.
• Facilitates the implementation of local system and product consolidation efforts.
• Ensures compliance with regulatory and accreditation standards.
• Mentors, hires, trains, coaches, counsels, and evaluates the performance of direct reports.

Minimum Qualifications:

• Requires BS/BA in business administration or related healthcare field and a minimum of 8 years of experience in healthcare operations, finance, underwriting, actuary, network development and/or sales; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Strongly preferred MBA degree.
• Proven Network provider and contracting experience including Value-Based Care, Fee-for-Service and unit price contract experience.
• Excellent contracting, analytical and negotiation (listening) skills needed.
• Proven experience developing relationships both internal to the organization and external client facing.
• Experience in the New Jersey health insurance market.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $174,800 to $273,600. 

Locations:  Iselin, NJ, Morristown, NJ, New York, NY. 

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.  

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.