Network Advisor

Zelis • Morristown, TN

20h • Hybrid

About The Position

This role is responsible for management of designated network partner relationships within an assigned book of business with clear goals on retention, identifying growth opportunity and revenue optimization. Will work with Network Solutions leadership as well as the Business to deliver best-in-class service and provide proactive solutions to maintain positive network relationships.

Requirements

• Bachelors degree plus 2-4 yrs; Masters a plus
• Proficiency using AI tools skillfully with an understanding of how to develop/create intelligent prompts and/or agents
• Proven work experience in healthcare insurance industry as an Account Manager, Key Account Manager, Sales Account Manager, Junior Account Manager or relevant role
• Demonstrable ability to communicate, present and influence key stakeholders at all levels of an organization
• Demonstrated ability to retain and maximize existing block of business.
• Strong communication skills
• Ability to synthesize complex issues and communicate clearly to both network partners as well as internal stakeholders
• Proven ability to juggle multiple account management projects at a time, while maintaining sharp attention to detail
• Thorough knowledge of Excel and other MS Office products
• Experience utilizing SalesForce or other CRM tool

Responsibilities

• Lead monthly or quarterly check-ins with Network Partners and maintain log of open issues and initiatives for each assigned Network Partner
• Provide monthly updates on Networks within assigned block of business
• Maintain Implementation Guide for assigned Networks designed to foster retention and drive growth
• Analyze Network utilization on a quarterly basis to manage any mitigation of changes in volume
• Maintain rates for each assigned network partner, ensure rates are in line with client contracts in addition to maintaining network partner rates on published Network Rate Sheet
• Responsible for risk identification such as volume decrease, service gaps, changes in network level relationships and key advocates. Escalate to leadership as appropriate
• Acquire an understanding of network expectations, objectives, initiatives and opportunities for growth
• Demonstrate clear understanding of Zelis product/service value propositions
• Remain abreast of changing and evolving healthcare landscape, regulations and related health plan/payer trends
• Case management for inquiries from assigned network partners
• Partner with Project Management and Business Support throughout the implementation process of newly assigned networks.
• Fulfill specific implementation tasks as assigned
• Request network approval for new clients and communicate with Client Setup Team
• Partner with Strategic Account Management, Client Services, EDI Teams, and Accounting on client/network partner needs
• Coordinate with Zelis Third Party Risk Management for Network discussions and reviewing policy
• Participate in Network Solutions meetings
• Present own work to members of department and external consultants and external professional meetings
• Attend company training and regional training in area of expertise
• Maintain current overview and rules of engagement for network partners in Zelis tools and/or Customer Relationship Management (CRM) tools updated and provide consultation and assistance to team members as needed
• Maintain awareness of and ensure adherence to Zelis standards regarding privacy and security

Benefits

• 401k plan with employer match
• flexible paid time off
• holidays
• parental leaves
• life and disability insurance
• health benefits including medical, dental, vision, and prescription drug coverage

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level