Network Education Rep Senior

Anticipated End Date:

2025-10-24

Position Title:

Network Education Rep Senior

Job Description:

Network Education Rep Senior

Location: We are currently seeking people in the following counties and look forward to speaking with you! (Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee)

Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

• Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Network Education Rep Senior supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy. Develops and provides a standard orientation package for newly contracted providers. Promotes technology and skills development to improve provider business practices.

How you will make an impact:

• Provides/coordinates provider training for claims and billing procedures, contract compliance, medical management, and pharmacy issues.
• Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
• Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations.
• Facilities provider network by recruiting necessary PCP, Specialist, Ancillary, and Hospital providers and assisting Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.
• Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies.
• Mentors, coaches and trains lower level staff.
• Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies.

Minimum Requirements:

• Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience, which would provide an equivalent background.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

PND > Provider Relationship Account Mgmt

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated,