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# Network Relations Consultant

- **Company:** CareMore Health Management Services, LLC
- **Location:** Los Angeles, CA, United States
- **Experience:** Experienced
- **Salary:** $80,819.0 - $121,228.0
- **Contract:** Permanent contract
- **Skills:** Access Network, Network Administration
- **Published:** September 20, 2026
- **Apply:** https://www.indeed.com/viewjob?jk=bb98a5582de59527

## About the Role

* Requires a Bachelor's degree
 * 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.
 * Travels to worksite and other locations as necessary.

Quality and AWV

 * Consistent PCP visits focused on:
 * PAHAF completion, STARS gaps closed
 * HCC Re-capture rate,
 * PCP referrals

## Description

Network Management Consultant: will own individual performance engagement and on-the-ground relationship development for new and existing MDs.

 * Develops and maintains 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.
 * May be responsible for coordinating non-negotiated contracts for new and existing providers as needed.
 * Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.
 * May participation in Joint Operation Committees (JOC) of larger provider groups.
 * Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
 * Conducts seminars to support the understanding of managed care policies and procedures.
 * Identifies network access and deficiencies and develops recruitment and contracting strategies.
 * Coordinates and conducts provider training including developing and distributing provider relations materials.
 * Responsible for providing quality, accessible and comprehensive service to the company's provider community.
 * Provide assistance regarding education, contract questions and non-routine claim issues.
 * Coordinates communications process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
 * Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department.
 * Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery.
 * Tracks and conduct provider refresher training.
 * Researches issues that may impact future provider negotiations or jeopardize network retention.