Elevance Health
Overview
Position Title:
Network Relations Consultant
Anticipated End Date:
2025-09-15
Location:
Hybrid (office 1-2 days per week on-site with flexibility for virtual work). This approach promotes collaboration and work-life balance while maintaining productive in-office engagement.
The Network Relations Consultant develops and maintains positive provider relationships with the provider community by regular on-site visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
Responsibilities
Serve as a knowledge and resource expert regarding provider issues impacting provider satisfaction; research and resolve complex provider issues and appeals for prompt resolution.
Coordinate non-negotiated contracts for new and existing providers as needed.
Research, analyze, and recommend resolutions for contract disputes, non-routine claim issues, billing questions, and other practices.
Participate in Joint Operation Committees (JOC) of larger provider groups as applicable.
Coordinate communication on administrative and medical policy, reimbursement, and provider utilization patterns.
Conduct seminars to support understanding of managed care policies and procedures.
Identify network access issues and deficiencies; 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; assist with education, contract questions, and non-routine claim issues.
Track and conduct provider refresher training and research issues that may impact future provider negotiations or network retention.
Minimum Requirements
Requires a Bachelor's degree and a minimum of 3 years of customer service experience including 2 years experience as a Network Management Rep; or any combination of education and experience providing an equivalent background.
Preferred Skills, Capabilities, and Experiences
Provider facing experience strongly preferred.
Claims experience strongly preferred.
Maryland Medicaid experience preferred.
Billing from Provider experience preferred.
Salary, Location and Benefits Locations: Hanover, MD
For candidates working in person or virtually in the location(s) below, the salary range for this position is $64,512 to $96,768. In addition to salary, Elevance Health offers a comprehensive benefits package including incentive programs, retirement plans, and wellness options. Specific benefits are subject to eligibility requirements.
The salary offered is based on legitimate, non-discriminatory factors set by the Company and may vary by geographic location, work experience, education and/or skill level. Equal pay opportunities are provided in accordance with applicable laws.
Work Model and Regulations Elevation Health operates a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week unless specified as primarily virtual by the hiring manager. Time onsite requirements will be discussed during the hiring process.
Notice Elevance Health is an Equal Employment Opportunity employer. Qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law. Applicants who require accommodation to participate in the job application process may contact Elevance Health for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable laws.
#J-18808-Ljbffr
Network Relations Consultant
Anticipated End Date:
2025-09-15
Location:
Hybrid (office 1-2 days per week on-site with flexibility for virtual work). This approach promotes collaboration and work-life balance while maintaining productive in-office engagement.
The Network Relations Consultant develops and maintains positive provider relationships with the provider community by regular on-site visits, communicating administrative and programmatic changes, and facilitating education and the resolution of provider issues.
Responsibilities
Serve as a knowledge and resource expert regarding provider issues impacting provider satisfaction; research and resolve complex provider issues and appeals for prompt resolution.
Coordinate non-negotiated contracts for new and existing providers as needed.
Research, analyze, and recommend resolutions for contract disputes, non-routine claim issues, billing questions, and other practices.
Participate in Joint Operation Committees (JOC) of larger provider groups as applicable.
Coordinate communication on administrative and medical policy, reimbursement, and provider utilization patterns.
Conduct seminars to support understanding of managed care policies and procedures.
Identify network access issues and deficiencies; 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; assist with education, contract questions, and non-routine claim issues.
Track and conduct provider refresher training and research issues that may impact future provider negotiations or network retention.
Minimum Requirements
Requires a Bachelor's degree and a minimum of 3 years of customer service experience including 2 years experience as a Network Management Rep; or any combination of education and experience providing an equivalent background.
Preferred Skills, Capabilities, and Experiences
Provider facing experience strongly preferred.
Claims experience strongly preferred.
Maryland Medicaid experience preferred.
Billing from Provider experience preferred.
Salary, Location and Benefits Locations: Hanover, MD
For candidates working in person or virtually in the location(s) below, the salary range for this position is $64,512 to $96,768. In addition to salary, Elevance Health offers a comprehensive benefits package including incentive programs, retirement plans, and wellness options. Specific benefits are subject to eligibility requirements.
The salary offered is based on legitimate, non-discriminatory factors set by the Company and may vary by geographic location, work experience, education and/or skill level. Equal pay opportunities are provided in accordance with applicable laws.
Work Model and Regulations Elevation Health operates a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week unless specified as primarily virtual by the hiring manager. Time onsite requirements will be discussed during the hiring process.
Notice Elevance Health is an Equal Employment Opportunity employer. Qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law. Applicants who require accommodation to participate in the job application process may contact Elevance Health for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable laws.
#J-18808-Ljbffr