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LTSS Network Relations Consultant Sr
2 months ago
We are seeking a highly skilled LTSS Network Relations Consultant Sr to join our team at Elevance Health. As a key member of our organization, you will play a critical role in initiating, negotiating, and executing contracts with HCBS providers.
Key Responsibilities- Communicate contract terms, payment structures, and reimbursement rates to providers and maintain positive relationships
- Maintain and track contracts and documentation within a tracking system
- Assist with identifying and recruiting providers based on network composition and needs
- Serve as a knowledge expert regarding HCBS provider contracting
- Negotiate and execute contracts for new and existing providers
- Function as a high-level technical resource to resolve or facilitate complex provider issues
- Participate in Joint Operation Committees (JOC) of larger provider groups and participate in discussions of issues and changes
- Provide assistance regarding education, contract questions, and non-routine claim issues
- Coordinate communications on administrative and medical policy, reimbursement, and provider utilization patterns
- Coordinate prompt claims resolution through direct contact with providers, claims, pricing, and medical management department
- Identify and report on provider utilization patterns that have a direct impact on the quality of service delivery
- Track and conduct provider training
- Research issues that may impact future provider negotiations or jeopardize network retention
- Requires a Bachelor's degree and a minimum of 5 years of customer service experience, including 2 years' experience as a Network Management Rep
- Preferred qualifications include provider contracting skills, contract preparation and implementation, financial analysis, and rate proposal development
Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. We are committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
The salary range for this position is $67,680 to $121,824, based on a number of legitimate, non-discriminatory factors set by the Company. The actual compensation will vary depending on geographic location, work experience, education, and/or skill level.
