Description:
? Acts as the primary resource for assigned providers or groups to establish, oversee, and maintain positive relationships
? Assists with or responds to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues
? Optimizes interactions with assigned providers and internal business partners to establish productive professional relationships
? Monitors service capabilities and collaborates cross-functionally to ensure that needs of constituents are met
? Supports or assists with operational activities including database management and contract coordination
? Educates providers as needed to ensure compliance with contract policies and parameters
? Meets with key providers periodically to ensure service levels are meeting expectations
? Collaborates on implementation of large provider systems to manage cost drivers and execute specific cost initiatives
? Conducts standard provider recruitment, contracting, or re-contracting activities and assists with more complex contracting discussions
? May provide guidance and training to less experienced team members
Requirements: ? 3+ years' experience in business segment environment servicing providers with exposure to benefits and/or contract interpretation ? Working knowledge of business segment specific codes, products, and terminology ? 3-5 years' experience with business segment specific policy, benefits, plan design and language ? Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills
Benefits:
? Affordable medical plan options
? 401(k) plan (including matching company contributions)
? Employee stock purchase plan
? No-cost programs including wellness screenings, tobacco cessation and weight management programs
? Confidential counseling and financial coaching
? Paid time off
? Flexible work schedules
? Family leave
? Dependent care resources
? Colleague assistance programs
? Tuition assistance
? Retiree medical access
? Many other benefits depending on eligibility
