Elevance Health
Job Overview
Anticipated End Date: 2025-10-24
Position Title: Network Education Rep Senior
Location: Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo, Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee
Network Education Rep Senior Supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy. Develops and provides a standard orientation package for newly contracted providers. Promotes technology and skills development to improve provider business practices.
How you will make an impact
Provides/coordinates provider training for claims and billing procedures, contract compliance, medical management, and pharmacy issues.
Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations.
Facilitates provider network by recruiting necessary PCP, Specialist, Ancillary, and Hospital providers and assisting Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.
Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies.
Mentors, coaches and trains lower level staff.
Reviews state and national programs, trends and literature regarding provider issues and recommends appropriate strategies.
Minimum Requirements
Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience that would provide an equivalent background.
Job Level Non-Management Exempt
Legal EEO Statement 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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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Position Title: Network Education Rep Senior
Location: Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo, Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee
Network Education Rep Senior Supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy. Develops and provides a standard orientation package for newly contracted providers. Promotes technology and skills development to improve provider business practices.
How you will make an impact
Provides/coordinates provider training for claims and billing procedures, contract compliance, medical management, and pharmacy issues.
Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations.
Facilitates provider network by recruiting necessary PCP, Specialist, Ancillary, and Hospital providers and assisting Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.
Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies.
Mentors, coaches and trains lower level staff.
Reviews state and national programs, trends and literature regarding provider issues and recommends appropriate strategies.
Minimum Requirements
Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience that would provide an equivalent background.
Job Level Non-Management Exempt
Legal EEO Statement 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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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