Network Specialist ensuring stable, secure network operations across multiple locations for TQG. Collaborating with teams for network optimizations, implementations, and lifecycle management in hybrid work environment.
About the role
- Provider Network Consultant responsible for educating and training contracting provider community. Requires travel and adherence to financial requirements in health care services.
Responsibilities
- developing and maintaining cooperative working relationships with the contracting provider community
- educating, training, researching/processing claims issues
- identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed
- Ability and willingness to travel, including overnight stays
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 direct 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 within assigned areas for responsibility, including overnight stays
- Extensive knowledge of contracts, applications, and products
- Demonstrated proficiency in provider reimbursement methods
- 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 well under pressure
- Working knowledge of software, including Microsoft Office
Benefits
- health and wellness benefits
- 401(k) savings plan
- pension plan
- paid time off
- paid parental leave
- disability insurance
- supplemental life insurance
- employee assistance program
- paid holidays
- tuition reimbursement
Job title
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