Provider Relationship Account Consultant

Provider Relationship Account Consultant

Location : Overland Park KS, Wichita KS

Hours : M F Standard Working Hours

Travel : This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

Position Overview

Responsible for providing quality, accessible and comprehensive service to the company's provider community. Develops and maintains positive provider relationships with provider community via a mixture of email, telephonic and / or face-to-face outreach, by communicating administrative and programmatic changes, facilitating provider education and the resolution of provider issues.

How You Will Make an Impact

Collaborates with internal matrix partners to triage issues and submit work requests

Generally assigned to a portfolio of providers within a defined cohort

Researches, analyzes, and coordinates prompt resolution to provider issues and appeals through direct contact with providers and internal matrixed partners

Coordinates communication process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns

Conducts routine outreach to support the understanding of managed care policies and procedures, as well as outreach on a variety of initiatives and programs

Coordinates and conducts provider training including developing and distributing provider relations materials

May assist with Annual Provider Satisfaction Surveys, required corrective action plan implementation and monitoring education and non-routine claim issues

May coordinate Provider Manual updates / maintenance

Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery

Research issues that may impact future provider contract negotiations or jeopardize network retention

Required Qualifications

Requires a bachelor's degree; a minimum of 2 years of customer service experience including 1 year of experience in a healthcare or provider environment; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications

Travel to worksite and other locations as necessary

Claims experience is strongly preferred

Kansas Medicaid regulatory knowledge strongly preferred

Kansas Provider specific experience preferred

Provider Servicing experience strongly preferred

Job Level : Non-Management Exempt

Workshift : 1st Shift (United States of America)

Job Family : PND >

Provider Relationship Account Mgmt

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.