Network Relations Consultant - Training and Education

Anticipated End Date:

2026-06-15

Position Title:

Network Relations Consultant - Training and Education

Job Description:

Network Relations Consultant - Training and Education

Location: Hybrid1: This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.  This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.  Alternate locations may be considered.

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 Relations Consultant - Training and Education develops and maintains positive provider relationships with provider community by regular on-site visits, communicating administrative and programmatic changes, and facilitating, education and the resolution of provider issues.

How you will make an impact:

• Serving as a knowledge and resource expert regarding provider issues impacting provider satisfaction, researching and offering insight for complex provider issues.
• Responsible for provider education and training
• Coordination with quality improvement teams for process and procedure enhancements
• Researches, analyzes, and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.
• Participation with state stakeholders for regular cadence monthly provider education meetings.   
• May assist with implementation and provider training.
• Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
• Conducts seminars to provide information related to focused subjects including managed care policies and procedures.
• Identifies network access and deficiencies and develops recruitment and contracting strategies.
• Coordinates and conducts provider training including developing and distributing provider relations materials.
• Responsible for providing quality, accessible and comprehensive service to the company's provider community.
• Provide assistance regarding education, contract questions, and non-routine claim issues.
• Coordinates communications process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns.
• Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery.
• Tracks and conduct provider refresher training.
• Research issues that may impact future provider negotiations or jeopardize network retention.  
• Create training documents, presentations, and provider notices to inform providers of changes in policies and procedures

Minimum Requirements:

• Requires a Bachelor's degree and a minimum of 3 years of customer service experience including 2 years experience as a Network Management Rep; or any combination of education and experience, which would provide an equivalent background.  
• Travels to worksite and other locations as necessary.

Preferred Skills, Capabilities and Experiences:

• Section 508 compliance and training experience preferred.
• Provider training and education experience preferred.
• Intermediate-level Microsoft Office Suite experience preferred