Network Relations Consultant
4 days ago
Job Summary: We are seeking a skilled Network Relations Consultant to join our team at Elevance Health. As a key member of our organization, you will be responsible for developing and maintaining positive relationships with healthcare providers in the Kansas region.
Key Responsibilities:
- Develop and implement strategies to improve provider satisfaction and engagement
- Communicate administrative and programmatic changes to providers
- Facilitate education and resolution of provider issues
- Research and resolve complex provider issues and appeals
- Coordinate non-negotiated contracts for new and existing providers
- Research, analyze, and recommend resolution for contract disputes and non-routine claim issues
- Participate in Joint Operation Committees (JOC) of larger provider groups
- Coordinate communication process on administrative and medical policy, reimbursement, and provider utilization patterns
- Conduct seminars to support understanding of managed care policies and procedures
- Identify network access and deficiencies and develop recruitment and contracting strategies
- Coordinate and conduct provider training, including developing and distributing provider relations materials
- Provide quality, accessible, and comprehensive service to the company's provider community
Requirements:
- Bachelor's degree and a minimum of 3 years of customer service experience, including 2 years as a Network Management Rep
- Previous experience providing resolution of issues, including enrollment/eligibility determinations, credentialing issues, authorization issues, and claims processing/payment disputes
About Elevance Health:
Elevance Health is a health company dedicated to improving lives and communities. 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.
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