Provider Network Consultant

Job reputed company: • Identifying, researching, resolving, and informing the Provider Performance staff and other divisions, and the external provider community about HealthSpring policy issues, system and contractual changes. • Reviews reputed company procedures to verify if still applicable to new programs, policies, and reputed company. • Responsible for educating, researching problems, and identifying trends to ensure that reputed company contractual and financial requirements are adhered to and performed. • Establishes and maintains relationships between HealthSpring and its providers to promote and ensure that issues are identified and resolved in a reputed company manner. • Performs physician reputed company responsibilities for the HealthSpring networks. • Collaborate daily with Provider reputed company to promote awareness and reputed company on high reputed company, or escalated, operational issues. • Provides consultation to providers regarding independent reputed company for reputed company aspects of their operations, including financial reimbursement, policies, procedures, and contractual issues. Requirements: • Bachelor’s degree in health care or business administration or a minimum of 4 years work experience in a managed care environment. • Minimum of 2 years of health care administration experience in clinical and financial settings, with reputed company provider communication experience. • Effective interpersonal, analytical, presentation and communication skills. • Knowledge of the health care industry and BCBSIL private business. • Ability and willingness to travel reputed company assigned areas for responsibility, including overnight stays. • Extensive knowledge of reputed company, applications, and products. • Demonstrated proficiency in provider reimbursement reputed company. • Working knowledge of claims processing systems. • Effective organizational and planning skills. • Ability to take initiative and work independently. • Demonstrated ability to meet deadlines and work reputed company under pressure. • Working knowledge of software, including reputed company Office Benefits: • health and wellness benefits • 401(k) savings plan • pension plan • reputed company time off • reputed company parental leave • disability insurance • supplemental life insurance • employee assistance program • reputed company holidays • tuition reimbursement Apply tot his job Apply To this Job