Provider Network Consultant I-Mobile
Mobile - Alabama (AL),
Blue Cross and Blue Shield of Alabama
Healthcare Networks develops pricing and reimbursement strategies, credentials, educates and supports our provider partners to establish shared accountability to include the delivery of appropriate, high quality, cost-effective care. Network Services serves as the liaison between the provider community and Blue Cross, by managing networks, building relationships, providing education, and identifying and resolving problems.
The Provider Network Consultant I serves as a consultant and corporate liaison to health care providers, external vendors, and other internal stakeholders in key areas of the Company. Health care providers served include physicians, hospital administrators, and all ancillary providers. The overall role is providing both contracting and consultative services to the provider community, developing and promoting corporate objectives, solutions and services, and supporting providers with all administrative aspects of healthcare delivery. The goal of providing consultative services is to guide providers in a way that positively impacts all aspects of their administrative and clinical efficiency/effectiveness to assist in providing the highest quality and most cost effective healthcare to Blue Cross and Blue Shield of Alabama members. The position must interact with all levels of the Company and also participate in corporate level projects and initiatives. The incumbent is expected to interact via phone, email, and in on-site or off-site face to face meetings with providers, vendors, medical community leadership, and other key areas of the Company independently with minimal management intervention. The incumbent must develop general knowledge of member and provider contract benefits, clinical guidelines, medical policy and claims processing for all lines business.
Summary of Qualifications
- Bachelor’s Degree
- Two years of experience working in the healthcare industry
- Experience in a position interpreting and communicating information orally and written
- Experience in a
Terms and Agreements
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