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Network Relations Specialist

  • Job Family: PND > Provider Relationship Account Mgmt
  • Type: Full time
  • Date Posted:
  • Req #: JR32392

Location:

  • Iowa, Iowa

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Description

Title : Network Relations Specialist 
Location : Remote within Iowa with a 25% - 50% travel requirement. 
Hours : Standard 

Build the possibilities. Make an extraordinary impact:

Develops and maintains positive relations with physicians, providers and practice managers within a local health plan's provider delivery system. Researches and resolves operational issues. 

How you will make an impact:

  • Works directly with LTSS providers to provide support, training and education.
  • Coordinates service initiation/timely access, conduct site visits, ensures network adequacy, collaborates with contracting, serve as a SME and provides dedicated support to drive growth and retention of LTSS providers.
  • Works with MBUs operational departments to address LTSS provider grievances and service issues. 
  • Provides explanations to LTSS providers regarding contract compliance, 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 information. 
  • Develops and enhances training programs for LTSS providers. 
  • Conducts LTSS provider seminars and presentations on company networks, business operations, procedures and protocols. 
  • Functions as a high level technical resource to resolve or facilitate complex LTSS provider issues. 
  • Develops new LTSS provider programs and addresses major issues related to systems, customer service issues, new network implementation, etc. Instructs, trains, directs and checks the work of others. 

Minimum Requirements:

  • Requires a BA/BS degree and a minimum of 3 years experience as Network Services Specialist or as a Trainer; 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. 
  • Experience with MS Office, particularly PowerPoint and Excel. 
  • Strong Medicaid LTSS claims experience. 
  • Experience presenting in groups of varying sizes. 

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 careers.ElevanceHealth.com. 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 ability@icareerhelp.com for assistance.

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