Provider Network Consultant

Health Care Service Corporation • Chicago, IL

265d • $54,800 - $121,100

About The Position

This position is responsible for developing and maintaining cooperative working relationships with the contracting provider community; educating, training, researching problems; and identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed. Ability and willingness to travel, including overnight stays.

Requirements

• Bachelor's degree in health care or business administration or a minimum of 4 years work experience in a managed care environment.
• Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
• Effective interpersonal, analytical, presentation and communication skills.
• Knowledge of the health care industry and BCBSIL private business.
• Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
• Extensive knowledge of contracts, applications, and products.
• Demonstrated proficiency in provider reimbursement methods.
• Working knowledge of claims processing systems.
• Effective organizational and planning skills.
• Ability to take initiative and work independently.
• Demonstrated ability to meet deadlines and work well under pressure.
• Working knowledge of software, including Microsoft Office.

Responsibilities

• Develop and maintain cooperative working relationships with the contracting provider community.
• Educate and train providers on contractual and financial requirements.
• Research problems and identify trends within the provider community.
• Evaluate providers to ensure compliance with contractual obligations.

Benefits

• Health and wellness benefits
• 401(k) savings plan
• Pension plan
• Paid time off
• Paid parental leave
• Disability insurance
• Supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement
• Annual incentive bonus plan

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree