Network Relations Consultant
1 day ago
We are seeking a highly skilled Network Relations Consultant to join our team at Elevance Health. As a key member of our organization, you will play a critical role in developing and maintaining positive relationships with our provider community.
Key Responsibilities:- Develop and maintain strong relationships with healthcare providers to ensure high-quality care and services.
- Communicate administrative and programmatic changes to providers, ensuring seamless implementation and minimal disruption.
- Facilitate education and resolution of provider issues, promoting a collaborative and supportive environment.
- Research and resolve complex provider issues and appeals, ensuring prompt and effective resolution.
- Coordinate non-negotiated contracts for new and existing providers, ensuring compliance with company policies and procedures.
- Research, analyze, and recommend resolutions for contract disputes, non-routine claim issues, and billing questions.
- Participate in Joint Operation Committees (JOC) of larger provider groups, fostering collaboration and cooperation.
- Coordinate communication processes on administrative and medical policy, reimbursement, and provider utilization patterns.
- Conduct seminars to support understanding of managed care policies and procedures, promoting education and awareness.
- Identify network access and deficiencies, developing recruitment and contracting strategies to address gaps.
- Coordinate and conduct provider training, developing and distributing provider relations materials.
- Provide quality, accessible, and comprehensive service to the company's provider community, ensuring exceptional customer experience.
- Bachelor's degree in a related field, such as healthcare administration or business.
- Minimum of 3 years of customer service experience, including 2 years as a Network Management Representative.
- Strong communication and interpersonal skills, with ability to build and maintain relationships with diverse stakeholders.
- Ability to analyze complex issues and develop effective solutions, promoting a collaborative and supportive environment.
- Proficiency in Microsoft Office and other relevant software applications.
- Long-term care experience.
- Assisted living facilities experience.
- Experience working with Medicaid providers.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.
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