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Network Education Representative Sr.

1 month ago

Topeka, United States Elevance Health Full time

LTSS Network Education Representative Sr

Location : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of our Topeka, Kansas Elevance Health PulsePoint locations.

The LTSS Network Education Rep Sr is responsible for enhancing and overseeing a comprehensive initial and ongoing provider training and communication plan, ensuring the provider network has the resources, tools, and supports necessary to deliver high-quality care to members. This specialist position will demonstrate, teach, and guide external LTSS providers through customer service including training, contracting assistance, claims resolution and advocacy.

How you will make an impact:

Primary duties may include, but are not limited to:

  • Provides/coordinates provider training for programs, services, claims and billing procedures, contract compliance and special health care needs of members

  • Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.

  • Develops and provides a standard orientation package for newly contracted providers.

  • Promotes technology and skills development to improve provider business practices.

  • Supports the efficacy of contractual agreements with all providers to ensure compliance with local/state/federal regulations.

  • Coordinates, advertises, and tracks attendance for internal and external trainings, identifying gaps and ad-hoc training needs

  • Works collaboratively with Network Support, Contracting, and Credentialing associates to ensure LTSS credentialing standards are followed, maintaining accurate provider data.

  • Provides leadership in the development of provider education and internal health plan support to mitigate issues related to provider operations, contracting and provider claims submissions.

  • Mentors, coaches and trains peers. Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies.

Minimum Requirements:

Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

  • Experience training and coaching providers on services, programs, billing, state and Federal requirements.

  • Experience working for and/or with Kansas LTSS/HCBS providers

  • Previous experience with provider education and training is very strongly preferred.

  • Knowledge in available Kansas Medicaid programs and resources.

  • Medicaid or LTSS claims experience.

  • Very strong written and verbal communication skills.