What are the responsibilities and job description for the Network Services Advisor position at Zelis?
Position Overview
The Network Services Advisor will have responsibility for management of designated leased network partner relationships within an assigned book of business with clear goals on retention, identifying growth opportunity and revenue optimization. Will work with VP and Director, Network Solutions as well as the Business to deliver best-in-class service and provide proactive solutions to maintain positive network relationships.
Key Responsibilities
Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.
Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.
Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com.
SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.
The Network Services Advisor will have responsibility for management of designated leased network partner relationships within an assigned book of business with clear goals on retention, identifying growth opportunity and revenue optimization. Will work with VP and Director, Network Solutions as well as the Business to deliver best-in-class service and provide proactive solutions to maintain positive network relationships.
Key Responsibilities
- Lead monthly or quarterly check-ins with Network Partners; maintain log of open issues and initiatives for each assigned Network Partner
- Provide monthly updates on Networks within assigned block of business
- Maintain Implementation Guide for assigned Networks designed to foster retention and drive growth; update at least quarterly
- Analyze Network utilization on a quarterly basis to manage any mitigation of changes in volume
- Maintain rates for each assigned network partner, ensure rates are in line with client contracts in addition to maintaining network partner rates on published Network Rate Sheet
- Responsible for risk identification such as volume decrease, service gaps, changes in network level relationships and key advocates. Escalate to VP Network Solutions as appropriate.
- Acquire an understanding of network expectations, objectives, initiatives and opportunities for growth
- Demonstrate clear understanding of Zelis product/service value propositions
- Remain abreast of changing and evolving healthcare landscape, regulations and related health plan/payer trends
- Case management for inquiries from assigned network partners.
- Partner with Project Management and Business Support throughout the implementation process of newly assigned networks. Fulfill specific implementation tasks as assigned.
- Request network approval for new clients and communicate with Client Setup Team.
- Partner with Strategic Account Management, Client Services, EDI Teams, and Accounting on client/network partner needs
- Coordinate with Zelis Third Party Risk Management for Network discussions and reviewing policy
- Participate in Network Solutions meetings
- Maintain current overview and rules of engagement for network partners in Zelis tools and/or Customer Relationship Management (CRM) tools updated; provide consultation and assistance to team members as needed
- Maintain awareness of and ensure adherence to Zelis standards regarding privacy and security
- 8 years’ experience working with/for Health Insurance companies, TPAs or PPO Networks in account management or similar role
- Proven work experience as an Account Manager, Key Account Manager, Sales Account Manager, Junior Account Manager or relevant role
- Demonstrable ability to communicate, present and influence key stakeholders at all levels of an organization, including executive and C-level
- Developed knowledge of assigned network base
- Demonstrated ability to retain and maximize existing block of business
- Strong communication skills; ability to synthesize complex issues and communicate clearly to both network partners as well as internal stakeholders
- Proven ability to juggle multiple account management projects at a time, while maintaining sharp attention to detail
- Thorough knowledge of Excel and other MS Office products
- Experience utilizing SalesForce or other CRM tool.
Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.
Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.
Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com.
SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.
