Consultant

Job Description

Provider Experience Consultant

Locations : Woodland Hills, CA; Denver, CO; Atlanta, GA; Indianapolis, IN; Chicago, IL; Las Vegas, NV; New York, NY; Seven Hills, OH;

Grand Prairie, TX; Norfolk, VA; and Waukesha, WI

21215 Burbank Blvd., Woodland Hills, CA 91367

700 Broadway, Denver, CO 80273

740 W Peachtree St. NW, Atlanta, GA 30308

220 Virginia Ave., Indianapolis, IN 46204

233 S Wacker Dr., STE 3700, Chicago, IL 60606

One Penn Plaza, 35th and 36th FL, New York, NY 10019

9133 W Russell Rd., Las Vegas, NV 89148

6000 Lombardo Center, STE 200, Seven Hills, OH 44131

2505 N Hwy. 360, Grand Prairie, TX 75050

5800 Northampton Blvd., Norfolk, VA 23502

N17W24222 Riverwood Dr., STE 300, Waukesha, WI 53188

This position will take part in Elevance Health's hybrid workforce strategy which includes virtual work and 1-2 days physically in office per week .

Associates are required to live within a 50-mile radius and a 1-hour commute to one of our Elevance Health major office (PulsePoint) locations listed above.

Elevance Health supports a hybrid workplace model with PulsePoint sites used for collaboration, community, and connection.

The Provider Experience Consultant is responsible for providing quality, accessible and comprehensive service to the company's provider community.

How You Will Make an Impact

Primary duties may include, but are not limited to :

Develops and maintains positive provider relationships with the 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.

Travels to worksite and other locations as necessary.

Minimum Requirements :

or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences :

Experience working with commercial, Medicare Advantage and Medicaid claims strongly preferred.

Proficient in Microsoft Office Programs; specifically intermediate level Excel skills to include using pivot tables, VLOOKUP, creating and using formulas, and the ability to sort and filter large sets of data.

Proficiency in Microsoft Office Suite with an emphasis on Excel capabilities. Expertise in utilizing pivot tables, incorporating VLOOKUP, formulating and applying intricate formulas, along with the ability to streamline and categorize extensive data sets strongly preferred.

Robust written and oral communication skills.

Exceptional time management and project management skills to efficiently balance and guide various tasks and projects.

For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $56,880.

00 to $102,384.00 annually.

Locations : California; Colorado; Nevada; 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.

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 considered to be 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.

Job Level :

Non-Management Exempt

Workshift : Job Family :

Job Family : PND >

PND >

Provider Relationship Account Mgmt

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.

Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

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.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates.

Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of 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.

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

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19.

If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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.

Applicants who require accommodation to participate in the job application process may contact for assistance.

Last updated : 2024-07-26

Salary : $56,880 - $102,384