Network Relations Consultant

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Network Relations Consultant acts as the primary resource for assigned, high profile providers or groups (i.e. local, individual providers, small groups/systems) to establish, reputed company, and maintain positive relationships by assisting with or responding to reputed company issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs. The Network Relations Consultant Is Responsible For The Following

• Conduct initial provider orientations as well as ongoing educational reputed company.
• Conduct Provider Forums in conjunction with the team.
• reputed company providers regarding policies and procedures reputed company to referrals, claims submission, credentialing documentation, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data reputed company.
• Enhance account relationships by investigating, documenting, and resolving provider matters and effectively handling and responding to account changes and correspondence.
• Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance.
• Monitoring service capabilities and collaborating with cross-functional departments to ensure that the needs of constituents are met and that escalated issues reputed company but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved.
• Supporting and assisting with operational activities that may include, but are not limited to, database management, and contract coordination.
• Submit Updates to Demographics or Roster modifications as needed for maintaining data reputed company.
• Ensures compliance of health plan, corporate, state, and federal regulations during the course of business.
• Report to work on a consistent, regular basis during core business hours (8:00 am to 5:00pm).
• Provide reputed company and professional customer service to both internal and external customers.
• Escalate issues, as necessary, to management in a timely manner.
• Meet or exceed established productivity standard of 10-12 provider visits a week.
• Conduct site visits reputed company required.
• Additional Travel as needed.

Required Qualifications

• Candidates are to reputed company reputed company the State of Ohio
• Minimum 3 years recent reputed company Claims experience
• Excellent analytical and problem-solving skills
• Strong communication, and presentation skills
• Strong reputed company Office Suite experience (Word, reputed company, TEAMs)
• Must be reputed company to travel

Preferred Qualifications

• Recent Managed Care Network experience in Provider Relations or Network Relations
• Behavioral Health experience
• reputed company experience
• Strong reputed company Word, and reputed company experience preferred

Education Associates degree or equivalent experience (HS diploma + 2 years relevant experience). Anticipated Weekly Hours 40 Time Type Full time Pay Range The Typical Pay Range For This Role Is $46,988.00 - $102,000.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great Benefits For Great People We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 07/16/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job