NETWORK RELATIONS CONSULTANT SR

NETWORK RELATIONS CONSULTANT SR 

Rancho Cordova, CA

Exp 5-7 yrs

Deg Bach

Relo

Bonus

Travel

Job Description

Manage the Provider Relations functions of ensuring quality customer service and acting as the primary liaison to the Plan's contracted providers to organize and conduct activities to maximize provider retention, interest and loyalty.

Oversee all provider outreach activities to ensure that education for providers and resolution of issues are delivered in an accurate, timely, professional and courteous manner. 

Plan, prepare, and present programs, materials and publications to participating providers.

Serve as a primary point of contact and resource to resolve issues raised by, or impacting, the Plan's providers and related support staff. 

Intervene with hospitals, physicians and other provider contractors to examine specific policies, procedures, complaints in a manner which yields a positive resolution that meets Plan standards, while maintaining provider satisfaction.

Organize and prepare materials and represent Plan at meetings.

Introduce and mainstream new products and improve and maintain existing products for providers.

Qualifications

Requires a BA/BS degree; 3-4 years of related experience; or any combination of education and experience, which would provide an equivalent background.

Requires excellent communication skills (written and verbal) and interpersonal skills

Must have strong customer service skills, time management and organizational skills

Must be able to communicate effectively to groups and individuals; be proficient orally and in writing to answer questions, training, directly, and/or working cooperatively with other staff to encourage teamwork and productivity.

Will be required to identify, anticipate and solve complex problems, and intervene on behalf of the Plan or a provider to resolve conflicts in a positive manner and to reach an acceptable result.

Must be able to work independently and assume responsibility for the completion of special projects in a timely manner.

Provider Relations experience is preferred

Health Insurance or managed care experience is preferred

Medicaid experience is preferred.

Requires experience navigating computer applications. 

Travel to provider offices, hospitals, health fairs may be required