Network Relations Specialist
1 week ago
Elevance Health is a health company dedicated to improving lives and communities. We are seeking a Network Relations Consultant to join our team.
SalaryThe estimated salary for this position is $80,000 - $120,000 per year, based on location and experience.
Job DescriptionWe are looking for a skilled professional to develop and maintain positive provider relationships with the provider community. This includes regular on-site visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
Key Responsibilities- Researches and analyzes contract disputes, non-routine claim issues, billing questions, and other practices.
- May participate in Joint Operation Committees (JOC) of larger provider groups.
- Coodinates communication processes on issues such as administrative and medical policy, reimbursement, and provider utilization patterns.
- Conducts seminars to support understanding of managed care policies and procedures.
- Coordinates and conducts provider training, including developing and distributing provider relations materials.
- Responsible for providing quality, accessible, and comprehensive service to the company's provider community.
- Provides assistance regarding education, contract questions, and non-routine claim issues.
- Coodinates prompt claims resolution through direct contact with providers, claims, pricing, and medical management department.
- Requires a Bachelor's Degree and a minimum of 3 years of customer service experience, including 2 years experience as a Network Management Rep.
- Experience with Medi-Cal and Medicare (D-SNP) managed care plans preferred.
We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We also offer comprehensive benefits, equity stock purchase, and 401(k) contribution.
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