Provider Network Consultant

Fully onsite

This position is responsible for providing supporting services, provider operations and contracting of individual and facility behavioral health providers. This position is accountable for researching and resolving provider inquiries arising from contract operations, system, and directory issues. This position is responsible for internal communications including working with Provider Network and Provider Relations team members and staff related to contract and network build initiatives and issue resolution. This position is responsible for external communications including educating and updating the BH provider network community regarding Client Cross policy updates, system and contractual changes. Assist the team to build a fast paced BH provider network project with a tight deadline.

JOB REQUIREMENTS:

• Bachelor degree OR 2 years of experience in health insurance/managed care industry for behavioral health providers and/or facilities in order handling independent decision making. Written and verbal communication skills to compose responses to external and internal entities
• To educate providers
• To compose training materials and procedures
• To work across departments to resolve provider contracting barriers
• Candidate must be PC proficiency in Microsoft tools including but not limited to Microsoft Outlook, Word, Excel, PowerPoint and Adobe PDF.

PREFERRED JOB REQUIREMENTS:

• Bachelor Degree with one year business experience.
• Knowledge of health care industry, contracts, products, claims processing.
• Knowledge of behavioral health services to support contracting efforts.