Provider Relationship Account Consultant

Provider Relationship Account Consultant 2 days ago Be among the first 25 applicants Provider Relationship Account Consultant Location: This 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. Ideal candidates will be able to report to our Pulse Point location in Latham, NY. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Provider Relationship Account Consultant will be responsible for providing quality, accessible and comprehensive service to the company's provider community. A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. 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. 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. 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 Skills, Capabilities, and Experiences Provider customer service experience preferred. Strong communication (verbal and written) skills to resolve workplace/client conflicts ensuring all parties feel heard and respected preferred. Working knowledge of Microsoft Excel and Word preferred. Experience with claims/provider systems (i.e., Facets, WGS, and/or SPS) preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $60,816 to $104,256. Location(s): New York In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. Salary range: $60,816 to $104,256 (based on location, experience, education, and skill level; actual compensation may vary). We are an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, and local laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. #J-18808-Ljbffr Elevance Health