Network Relations Consultant

6 days ago


Topeka, Kansas, United States Elevance Health Full time
Job Title: Network Relations Consultant

At Elevance Health, we are seeking a skilled Network Relations Consultant to join our team. As a key member of our organization, you will play a critical role in developing and maintaining positive provider relationships with the Kansas LTSS provider community.

Key Responsibilities:
  • Develop and maintain strong relationships with LTSS providers to ensure seamless communication and collaboration.
  • Conduct regular on-site visits to providers to address administrative and programmatic changes, facilitate education, and resolve provider issues.
  • Research and resolve complex provider issues and appeals in a timely manner.
  • Coordinate non-negotiated contracts for new and existing providers as needed.
  • Participate in Joint Operation Committees (JOC) of larger provider groups to foster collaboration and knowledge sharing.
  • 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 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.

We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. Elevance Health operates in a Hybrid Workforce Strategy, and associates are required to work at an Elevance Health location at least once per week. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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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