TOPEKA, KS, 66625, USA
10 days ago
Provider Relationship Account Consultant
**Location:** Olathe Kansas or Topeka Kansas **Travel:** Field Based Position (Travel across the state of Kansas to provider sites as needed) **Position Overview:** Responsible for providing quality, accessible and comprehensive service to the company's provider community **How You Will Make an Impact:** + Develops and maintains positive provider relationships with 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 **Required Qualifications:** + 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 Qualifications:** + Travels to worksite and other locations as necessary
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