Network Relations II

CorVel Career Site•Glen Allen, VA

2d•Remote

About The Position

The Network Relations II role supports the frontline of Network Development by providing customer service and overseeing provider data integrity. The position combines interpersonal skills with knowledge of the medical provider market and is remote. The role supports implementation of medical providers, reviews provider credentials and documentation, assists with provider orientation and liaison activities, resolves contract and payment disputes, and responds to staff requests for network information. It also oversees contract distribution and database maintenance, provider data audits and updates, roster updates, and site surveys as needed. Additional work includes supporting network marketing, employer and payor relations, product development, and identifying specialties for provider recruitment. CorVel describes itself as a national provider of risk management solutions for workers’ compensation, auto, health, and disability management. Full-time regular employees are eligible for a comprehensive benefits package. The stated pay range is $19.24–$31.04 per hour; pay may vary based on location, skills, experience, qualifications, internal equity, and market conditions.

Requirements

Associate’s degree or two or more years of equivalent work experience.
Customer service education or training within the insurance industry, managed care, or a related field.
Strong interpersonal skills and an adaptive communication style.
Complex problem-solving skills and innovation.
Ability to adapt quickly to process changes.
Ability to prioritize and manage scheduled or unscheduled assignments.
Ability to embrace new tools and procedures in accordance with corporate guidelines and objectives.
Strong organizational skills.
Excellent written and verbal communication skills.
Attention to detail and ability to deliver results in a fast-paced, dynamic environment.
Proficiency in Microsoft Office applications.

Responsibilities

Assist the Developer with implementing medical providers using written and verbal communication.
Verify provider signatures, contracts, and documentation before submitting them for internal processing.
Review credentials of prospective providers for acceptance into the network in accordance with national credentialing requirements and protocols.
Provide orientation on managed care procedures and establish liaisons with participating providers.
Assist with and communicate about the provider orientation program in cooperation with the Developer.
Distribute and maintain provider manuals and orientation materials in accordance with state guidelines.
Receive and resolve disputes involving provider contract and payment issues in accordance with contract dispute resolution procedures.
Respond to staff requests for information about the network, locally and nationally.
Oversee distribution of executed contracts and maintenance of the database.
Assist with network marketing, employer and payor relations, and product development.
Conduct and manage provider data audits to ensure network data integrity, and oversee provider updates and changes with NDB.
Coordinate and process provider roster updates at least annually or as otherwise required.
Perform facility site surveys as needed under credentialing requirements or state guidelines.
Identify specialties within the network and generate a recruitment list for the Developer.
Perform additional duties as assigned.