Title : Network Relations Specialist
Location : Remote within Iowa with a 25% - 50% travel requirement.
Hours : Standard
Build the possibilities. Make an extraordinary impact:
Responsible for providing quality, accessible and comprehensive service to the LTSS provider network by developing and maintaining positive relationships, as well as serving as the liaison between the health plan and to provider. This role will support the provider with the resolution of operational issues and connect with appropriate resources for training and education.
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 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 firstname.lastname@example.org for assistance.