Network Management Consultant (contract)

Provides provider relations/network management consulting support to complex, high profile provider organizations. Serves as technical resource and mentor to other consultants.

Primary duties may include, but are not limited to:

• Develops network recruitment and retention strategies to ensure the retention and maintenance of high quality contracted providers.
• Conducts negotiations and leads contracting efforts with complex, high profile provider organizations to build and maintain a cost effective, accessible provider network. Identifies, researches and analyzes economic and professional provider practice patterns to develop recommendations for improvements.
• Consults with, educates and trains providers on innovative alternative reimbursement programs.
• Conducts seminars to support the understanding of managed care and BCBS policies and procedures.
• Participates in network expansion efforts to recruit new physician specialties or large physician groups.
• Researches, analyzes and recommends resolution for contract and reimbursement disputes, non-routine claim issues, billing questions and other practices.

• Requires a BA/BS degree and a minimum of 3 years experience in provider network management, utilization management or other health care field; or any combination of education and experience, which would provide an equivalent background.
• Project coordination or project management experience
• Strong organizational and time management skills
• Ability to analyze project and operational data to support decision-making
• Experience identifying, scoping, and defining data requirements across multiple stakeholders
• Ability to manage multiple priorities and meet tight deadlines
• Proficiency with Microsoft Excel, PowerPoint, Teams, and Smartsheet or Microsoft Project
• Strong written and verbal communication skills
• Meeting facilitation and documentation (agendas, minutes, follow-up)
• Ability to work across multiple business areas and stakeholders
• Healthcare operations or managed care experience preferred

Job Type: Contract opportunity.

Additional Details:

• M-F 8am-5pm PST
• Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

26.94 - 51.44 USD hourly

Additional Notes

The pay range is the range BCForward in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations.

Benefits Information

BCForward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. This does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).

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., Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.