Description
Location: Hybrid- Indianapolis or surrounding area
Hours: Standard
Travel: Travel may be required throughout the state of Indiana
Position Overview:
The HCBS Contracting Network Specialists would initiate, negotiate, and execute HCBS providers contracts and directly support recruitment and onboarding of those providers.
How You Will Make an Impact:
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The Provider Contracting Specialists would communicate contract terms, payment structures, and reimbursement rates to provider and maintains positive provider relationships
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Maintains and tracks contracts and documentation within a tracking system
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May assist with identifying and recruiting providers based on network composition and needs.
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Serving as a knowledge expert regarding HCBS provider contracting
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Responsible for negotiating and executing contracts for new and existing providers
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Functions as a high level technical resource to resolve or facilitate complex provider issues
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Participates in Joint Operation Committees (JOC) of larger provider groups and participates in the discussion of issues and changes
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Provide assistance regarding education, contract questions and non-routine claim issues
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Coordinates communications on such issues as administrative and medical policy, reimbursement and provider utilization patterns
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Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department
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Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery
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Tracks and conducts provider training
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Researches issues that may impact future provider negotiations or jeopardize network retention
Required Qualifications:
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Requires a Bachelor's degree and a minimum of 5 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.
Preferred Qualifications:
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Provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development is a must
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Provider contract negotiation and execution experience preferred
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Experience with HCBS Providers strongly preferred
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Experience managing credentialing processes preferred
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Provider recruitment experience preferred
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Experience with program implementations 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. A Fortune 20 company with a longstanding history in the healthcare industry, 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 in certain patient/member-facing roles 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. 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.