Care Management Extender, Peer Support Specialist
Elevance Health
Training Manager, Provider Relationships & Accounts
Elevance Health
full-time
Posted on:
Origin: • 🇺🇸 United States • New York
Visit company websiteSalary
💰 $69,048 - $118,368 per year
Job Level
Mid-LevelSenior
About the role
- Provide quality, accessible and comprehensive service to the company's provider community
- Develops and maintains positive provider relationships via on-site and/or virtual/digital visits
- Communicate administrative and programmatic changes and facilitate education and resolution of provider issues
- Serve as knowledge and resource expert regarding provider issues impacting provider satisfaction and network retention
- Research, analyze, and coordinate prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners
- Collaborate within a cohort of internal matrix partners to triage issues and submit work requests
- Coordinate Joint Operation Committees (JOC) and drive meetings discussing issues and changes
- Assist Annual Provider Satisfaction Surveys, corrective action plan implementation and monitoring education, contract questions and non-routine claim issues
- Coordinate communications on administrative and medical policy, reimbursement, and provider utilization patterns
- Conduct proactive outreach to support understanding of managed care policies, procedures, initiatives and programs
- Participate in external Provider Townhalls/Seminars and attend State Association conferences (e.g., MGMA, AFP, AAP, HFMA)
- Identify and report on provider utilization patterns and research issues that may impact contract negotiations or network retention
Requirements
- Requires a bachelor’s degree
- Minimum of 3 years of customer service experience including 2 years of experience in a healthcare or provider environment
- Or any combination of education and experience, which would provide an equivalent background
- Travels to worksite and other locations as necessary
- Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law
- Experience and familiarity with 508 compliance language strongly preferred
- Experience as Trainer and training processes preferred
- Experience with controlling training calendar preferred
- May require COVID-19 and Influenza vaccinations for certain patient/member-facing roles
