Network Relations Consultant

Elevance Health•Little Rock, AR

2d•Hybrid

About The Position

The Network Relations Consultant is responsible for developing and maintaining 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. Serving as a knowledge and resource expert regarding provider issues impacting provider satisfaction, researches and resolves complex provider issues and appeals for prompt resolution.

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, which would provide an equivalent background.

Nice To Haves

Experience working closely with providers both individually and in groups to develop strategies that make a positive impact strongly preferred.
Experience with MS Office, particularly PowerPoint and Excel, strongly preferred.
Strong Medicaid LTSS claims experience is strongly preferred.
Experience presenting in groups of varying sizes is strongly preferred.

Responsibilities

Develops and maintains positive provider relationships with the HCBS provider community through a mixture of email, telephonic, and face to face outreach, communicating administrative and programmatic changes, facilitating provider education/training.
Works directly with LTSS providers to provide support in the resolution of provider issues.
Coordinates service initiation/timely access, conduct site visits, ensures network adequacy, collaborates with contracting, serve as a subject matter expert and provides dedicated support to drive growth and retention of LTSS providers.
Works with other operational departments to address LTSS provider claims, grievances, and service issues.
Conducts routine outreach to LTSS providers regarding contract compliance, reimbursement policies, company procedures and policies, etc.
Recruits, orients, and provides high quality service to LTSS providers.
Participates in the identification of sufficient number and location of LTSS providers to meet area needs.
Assists Contract Management group during contract negotiation by conducting some analysis and obtaining necessary data/information.
May conduct LTSS provider seminars and/or presentations as requested by the state Medicaid agency, or other applicable provider associations.