Specialty Network Relations

5 days ago

Jacksonville, United States CorVel Corporation Full time

Specialty Network Relations associates complete data review and entry, issue resolution, program and service education, and development efforts regarding CorVel’s CareIQ ancillary healthcare provider networks. Specialty Network Relations is key to ensuring that participating network providers have maximum utility and a positive experience with CorVel’s Ancillary Care Solutions.

This is a remote position. To maintain continuity of business, Specialty Network Relations associates must work and reside in the Eastern and Central US Time zones.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Assists provider network managers and developers with administrative tasks Negotiate and secure single case agreements with out of network providers as needed Conduct and manage provider data audits that ensure provider network data integrity Provide onboarding orientation on managed care procedures and establish liaison(s) with all participating providers Direct and assist network provider groups through remediation plans Coordinate and process provider roster updates monthly or as otherwise required Coordinate provider remediation and follow up Receive and resolve all disputes involving provider contract and payment issues Research facility concerns and educate providers on expectations Coordinate and process provider refund requests Receive, interpret, and catalogue patient satisfaction surveys Uses bill history research, service file review, problem solving and critical thinking skills to resolve customer questions. Requires regular and consistent attendance. Meets departmental production and quality performance expectations. Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP). Additional duties as required.

KNOWLEDGE & SKILLS:

Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment Excellent written and verbal communication skills. Ability to meet designated deadlines Computer proficiency and technical aptitude with the ability to utilize MS Office and Proprietary Systems. Strong interpersonal, time management and organizational skills. Ability to maintain a professional and courteous demeanor that sets tone for complex telephonic conversations. Ability to work both independently and within a team environment.

EDUCATION & EXPERIENCE:

Bachelor’s Degree in Business Administration or related field is preferred At least 2 years prior, related experience required; demonstrated progressive responsibilities preferred

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $18.36 - $29.63 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

About CorVel

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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