Network Relations II

CorVel Corporation•Glen Allen, VA

4d•$19 - $31•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 provider implementation, contract and credential review, provider orientation, dispute resolution, staff information requests, contract distribution, network marketing and development, provider data auditing and updates, roster processing, site surveys, and provider recruitment planning.

Requirements

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.
Strong attention to detail and ability to deliver results in a fast-paced, dynamic environment.
Proficiency in Microsoft Office applications.
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.

Responsibilities

Assist the Developer with implementing medical providers through written and verbal communication.
Verify provider signatures, contracts, and documentation before submitting them for internal processing.
Review prospective provider credentials for acceptance into the network under 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 in 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.