at Elevance Health in CHICAGO, Illinois, United States
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:
+ Requires a bachelor’s degree; a minimum of 2 years of customer service experience including 1 year of experience in a healthcare or provider environment; 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.
