Provider Network Consultant

Provider Network Consultant

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.

Responsibilities

• Developing and maintaining cooperative working relationships with the contracting provider community.
• Educating, training, researching problems, and identifying trends.
• Evaluating providers to ensure contractual and financial requirements are adhered to and performed.

Preferred Qualifications

• Excellent communication and presentation skills.
• Ability to create clear, engaging training materials and job aids.
• Strong interpersonal skills and ability to collaborate across multiple departments.
• Strong organizational skills.
• Strong time management and multi-tasking abilities.