Network Relations Consultant

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

This position is not eligible for employment based sponsorship.

The Network Relations Consultant is responsible for developing and maintaining positive provider relationships with 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.

How you will make an impact :

• 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.

• 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.

Preferred Skills, Capabilities and Experiences:

• 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.

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.