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Network Management Consultant


  • Connecticut, Connecticut



Network Management Consultant
Schedule: Mon - Fri | 8:30a - 5p EST
Location: 100% Remote - preferred residency: Connecticut

Build the possibilities. Make an extraordinary impact: 

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

How you will make an impact (including but are not limited to): 

  • 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.
  • Responsible for developing and implementing strategies for meeting ambitious quality, clinical and network improvement goals in CT region 1 via strategic partnerships with providers, state agencies, advocacy groups and other community stakeholders.
  • Perform key presentations and analyses of profiling data within individual provider groups and across hospital systems with a focus on detailing patterns and trends in utilization and outcomes that identify (1) performance outliers and (2) opportunities for individual provider and network-wide improvement.

Minimum Requirements:

  • 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.

Preferred Skills, Capabilities, and Experiences:

  • Masters degree is highly preferred

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.

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