Consultant

• Responsible for providing quality, accessible and comprehensive service to the company's provider community
• Develops and maintains positive provider relationships via a mixture of email, telephonic and/or face-to-face outreach
• Collaborates with internal matrix partners to triage issues and submit work requests
• Researches, analyzes, and coordinates prompt resolution to provider issues and appeals through direct contact with providers and internal matrixed partners
• Coordinates communication process on administrative and medical policy, reimbursement, and provider utilization patterns
• Conducts routine outreach to support the understanding of managed care policies and procedures
• Coordinates and conducts provider training including developing and distributing provider relations materials
• Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery

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