Job Info
Description
LOCATION: This is a hybrid position requiring 1-2 days per week in the office. You must be within 50 miles of Richmond, Norfolk, or Roanoke, and Virginia residency is required.
HOURS: General business hours, Monday through Friday.
TRAVEL: Travels to worksite and other locations as necessary.
The Network Education Representative Sr. supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy. Develops and provides a standard orientation package for newly contracted providers. Promotes technology and skills development to improve provider business practices.
Primary duties may include, but are not limited to:
- Provides/coordinates provider training for claims and billing procedures, contract compliance, programs, and special healthcare needs of members.
- Develops and promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
- Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations.
- Facilitates provider network by recruiting necessary LTSS providers and facilities, and support Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.
- Mentors, coaches and trains peers.
- Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies.
Required Qualifications - Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications - Previous LTSS experience is very strongly preferred.
- Very strong written and verbal communication skills are a must for this role.
- Previous experience with provider education and training is very strongly preferred.
- Must be knowledgeable in available Virginia Medicaid programs and resources.
- Medicaid or LTSS claims experience is very helpful.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.
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