Elevance Health
Join to apply for the
Network Relations Consultant
role at
Elevance Health .
The position will be based in the following counties: Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo, Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee.
Field: This field‑based role enables associates to primarily operate in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.
How You Will Make An Impact
Researches, analyzes and recommends resolution for contract dispute, non‑routine claim issues, billing questions and other practices.
Participates in Joint Operation Committees (JOC) of larger provider groups and coordinates communication process on administrative and medical policy, reimbursement and provider utilization patterns.
Conducts seminars to support the understanding of managed care policies and procedures.
Identifies network access and deficiencies and develops recruitment and contracting strategies.
Coordinates and conducts provider training, including developing and distributing provider relations materials.
Provides quality, accessible and comprehensive service to the company’s provider community.
Assists with education, contract questions and non‑routine claim issues.
Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department.
Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery.
Tracks and conducts provider refresher training.
Researches issues that may impact future provider negotiations or jeopardize network retention.
Minimum Requirements
Requires a Bachelor’s degree and a minimum of 3 years of customer service experience, including 2 years as a Network Management Representative, or an equivalent combination of education and experience.
Travels to worksite and other locations as necessary.
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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Network Relations Consultant
role at
Elevance Health .
The position will be based in the following counties: Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo, Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee.
Field: This field‑based role enables associates to primarily operate in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.
How You Will Make An Impact
Researches, analyzes and recommends resolution for contract dispute, non‑routine claim issues, billing questions and other practices.
Participates in Joint Operation Committees (JOC) of larger provider groups and coordinates communication process on administrative and medical policy, reimbursement and provider utilization patterns.
Conducts seminars to support the understanding of managed care policies and procedures.
Identifies network access and deficiencies and develops recruitment and contracting strategies.
Coordinates and conducts provider training, including developing and distributing provider relations materials.
Provides quality, accessible and comprehensive service to the company’s provider community.
Assists with education, contract questions and non‑routine claim issues.
Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department.
Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery.
Tracks and conducts provider refresher training.
Researches issues that may impact future provider negotiations or jeopardize network retention.
Minimum Requirements
Requires a Bachelor’s degree and a minimum of 3 years of customer service experience, including 2 years as a Network Management Representative, or an equivalent combination of education and experience.
Travels to worksite and other locations as necessary.
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.
#J-18808-Ljbffr