Network Relations Consultant

3 weeks ago

Wilmington, North Carolina, United States Johns Hopkins Medicine Full time

Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.

What awaits you:

  • Work-life balance - This is a remote role
  • Medical, Dental, and Vision Insurance.
  • 403B Savings Plan w/employer contribution.
  • Paid Time off & Paid holidays.
  • Employee and Dependent Tuition assistance benefits.
  • Health and wellness programs and MORE

What you'll do as a Network Relations Consultant:

  • You will develop and maintain a collaborative relationship with all network providers across all JHHP's lines of business.
  • Act as a liaison between the network providers and JHHP, monitoring network providers to ensure network access standards are met, ensure compliance with provider contract and regulatory processes and requirements, promoting JHHP's strategic initiatives and providing extensive training on all JHHP lines of business to ensure that network providers have updated policy and procedure information.
  • Educate and train providers on JHHP systems and quality goals.
  • Maintain ongoing communication with providers in assigned territory, facilitate regular provider meetings, and ensure timely assistance and resolution of any issues presented.

What you'll bring:

  • 2+ years' current experience in healthcare delivery program or insurance setting; experience should include:
    • Provider Relations functions
    • Managed care/provider contracting, familiarity with provider contract language and terms
    • Knowledge of managed care concepts and information systems (FACETS experience a plus).
  • Requires a sound knowledge of successful servicing, training, relationship building, negotiation techniques and an awareness of healthcare contracting terms.
  • Bachelor's degree in business management or healthcare administration or related discipline preferred.
  • Requires strong interpersonal skills to effectively communicate and interact with diverse groups of physicians, office staff, and business-related associates.
  • Requires basic computer skills and familiarity with various Microsoft software applications
  • Requires strong ability to prioritize multiple initiatives and assigned tasks.

Who we are:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.

Salary Range: Minimum 25.73 per hour - Maximum 42.48 per hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

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