Network Relations Consultant
18 hours ago
We are seeking a skilled Network Relations Consultant to join our team at Elevance Health. As a key member of our organization, you will play a vital role in developing and maintaining positive relationships with our provider community.
Key Responsibilities:- Develop and maintain strong relationships with healthcare providers through regular on-site visits, effective communication, and issue resolution.
- Serve as a knowledge expert on provider issues, researching and resolving complex problems to ensure prompt resolution.
- Coordinate non-negotiated contracts for new and existing providers, as needed.
- Research, analyze, and recommend solutions for contract disputes, non-routine claim issues, and billing questions.
- Participate in Joint Operation Committees (JOC) with larger provider groups to foster collaboration and communication.
- Coordinate communication processes on administrative and medical policy, reimbursement, and provider utilization patterns.
- Conduct seminars to educate providers on managed care policies and procedures.
- Identify network access and deficiencies, developing recruitment and contracting strategies to address these issues.
- Coordinate and conduct provider training, including developing and distributing provider relations materials.
- Provide high-quality, accessible, and comprehensive service to our provider community, addressing education, contract questions, and non-routine claim issues.
- Bachelor's degree and a minimum of 3 years of customer service experience, including 2 years as a Network Management Representative.
- Excellent communication, problem-solving, and analytical skills.
- Ability to work in a fast-paced environment and prioritize multiple tasks.
- Strong knowledge of healthcare policies, procedures, and regulations.
- 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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Network Relations Consultant
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