Network Relations Consultant

4 days ago


Topeka, Kansas, United States Elevance Health Full time
Job Description

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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