Provider Relationship Account Consultant

The Provider Relationship Account Consultant role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

About the role

The Provider Relationship Account Consultant is responsible for providing quality, accessible and comprehensive service to the company's provider community. How You Will Make An Impact:

• 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.
• 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.
• Captures and 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.
• Researches issues that may impact future provider contract negotiations or jeopardize network retention.

Responsibilities

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.

Qualifications

Preferred Skills, Capabilities And Experience:

• Travels to worksite and other locations as necessary.

Benefits

This position is not eligible for employment based sponsorship.

Pay

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.

Schedule

Associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

Equal Opportunity Employer

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.