Healthcare Network Consultant
1 week ago
The Network Management team is responsible for developing and maintaining all provider networks, including vendor and Plan to Plan relationships, to provide quality and affordable health care services to our members and clients.
Job Title: Provider Relations ConsultantThis role reports to the Provider Relations, Senior Manager, and supports Blue Shield of California's CalPERS line of business programs, including Plan to Plan operations.
Your Responsibilities:- Implement strategies with providers to improve provider performance.
- Develop and maintain good working relationships with the provider community.
- Serve as liaison between the company and the provider community to resolve questions or problems.
- Ensure provider compliance with company policies and contractual agreements.
- Identify potential network participants and promote provider participation in Blue Shield of California programs and networks.
- Conduct provider orientations and communicate company policies, procedures, products, or services.
- Aid with provider negotiations and manage complex provider relationships.
- Represent Network Management at internal meetings and present to stakeholders and/or Network Management leadership.
- Requires a college degree or equivalent experience and a minimum of 7 years of prior relevant experience.
- Requires excellent analytical and problem-solving skills.
- Requires deep knowledge of job area typically obtained through advanced education combined with experience.
- Requires a minimum of 3 years of Provider Relations experience.
- Requires experience in provider outreach and strong written and verbal communication skills.
The compensation range for this role is $96,470.00 to $144,760.00 for California.
Please note that this range represents the compensation range for this and many other positions at Blue Shield that fall into this compensation grade.
Blue Shield compensation is based on a variety of factors, including the candidate's experience, location, and current employee compensation for similar roles.
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