Provider Relations Representative, Consultant (Short Term Employment)
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About The Position
The Provider Relations Consultant plays a crucial role within the Network Management team at Blue Shield of California, focusing on the development and maintenance of provider networks. This position is integral to ensuring that members and clients have access to quality, affordable healthcare services. Reporting to the Provider Relations Senior Manager, the Consultant will specifically support the CalPERS line of business programs, which includes managing Plan to Plan operations. This is a short-term employment role, emphasizing the need for immediate contributions to the team. In this position, the Consultant will implement strategies aimed at enhancing provider performance and fostering strong working relationships within the provider community. Acting as a liaison, the Consultant will address various inquiries and issues related to contract interpretation, product implementation, and claims administration. Ensuring compliance with company policies and contractual agreements is a key responsibility, as is identifying potential network participants to promote their involvement in Blue Shield's programs. The Consultant will also conduct provider orientations, communicate essential company policies, and assist in negotiations, managing complex provider relationships effectively. The role requires collaboration across various functional areas, necessitating the ability to influence providers and cultivate business relationships with multiple stakeholders. The Consultant will represent Network Management in internal meetings, presenting updates and communicating on behalf of the team to leadership and other stakeholders. This position is designed for someone who can navigate the complexities of provider relations while contributing to the overall mission of Blue Shield of California to provide high-quality healthcare to all Californians.
