Network Relations Consult

Job ID: JP00045458

Anticipated Start Date: 04/07/2025

Please note this is the target date and is subject to change. Mindlance will send official notice ahead of a confirmed start date.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

Primary duties may include, but are not limited to:

• Develops and maintains positive provider relationships with provider community by regular on-site visits, communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues.
• Serving as a knowledge and resource expert regarding provider issues impacting provider satisfaction, researches and resolves complex provider issues and appeals for prompt resolution.
• May be responsible for coordinating non-negotiated contracts for new and existing providers as needed.
• Researches, analyzes, and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.
• May participate in Joint Operation Committees (JOC) of larger provider groups.
• Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
• Conducts seminars to support the understanding of managed care policies and procedures.
• Identifies network access and deficiencies and develops recruitment and contracting strategies.
• Coordinates and conducts provider training including developing and distributing provider relations materials.
• Responsible for providing quality, accessible and comprehensive service to the company's provider community.
• Provide assistance regarding education, contract questions and non-routine claim issues.
• Coordinates communications process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
• Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department.
• Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery.
• Tracks and conduct provider refresher training.
• Researches issues that may impact future provider negotiations or jeopardize network retention.

Requirements:

• Requires a Bachelor's degree and a minimum of 3 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.
• Travels to worksite and other locations as necessary.
• Experience with KanCare, the State, and Kansas Hospital Association.

Job Type: Contract with potential to hire.

Additional Details:

• Work location: 5901 COLLEGE BLVD, STE 275, Overland Park, KS, USA 66211.
• Monday-Friday 8-5.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

About Mindlance:

Founded in 1999, Mindlance is a certified diversity business and has been on the Staffing Industry Analysts list of Fastest-Growing US Staffing Firms twelve times. As a top-performing partner to leading workforce programs, Mindlance is known for delivering consistently high-quality tech first talent solutions. Our strong processes help clients build agile and diverse workforces, while creating an ease of onboarding and service to our consultants.

Mindlance provides specialized staffing solutions across the Healthcare industry and associated skill domains. Headquartered in Union, NJ with presence in over 40 key locations across US, Canada and India, servicing 200 global clients and 5000 consultants. Our services include Direct Sourcing, Global EoR & AoR, Payroll, Returnship, and Recruit-Train-Deploy solutions. With over $400 million in annual revenue, our success is rooted in a mindful commitment to balance in work, from which our name is derived.

Mindlance is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how Mindlance collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. Mindlance will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Salary : $400