Provider Network Consultant at HCSC focused on provider relationship management and compliance. Responsible for educating and evaluating providers to meet contractual obligations.
Responsibilities
Developing and maintaining cooperative working relationships with the contracting provider community
Educating, training, researching problems
Identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed
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
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