Provider Network Relations Consultant – IL, IN & MI

Socket.dev; Chicago (IL); On-site; USD 70,000 - 110,000; Full time

Job summary

Zing Health in Chicago seeks a Provider Network Relations Consultant to negotiate contracts and cultivate cooperative relationships with Medical Groups/IPAs, primary care, specialists, hospitals and ancillary Providers across the region.

You will serve as a liaison between network providers and Zing Health, monitor access standards, promote initiatives, provide training, collect credentialing documents, conduct orientations, and support reporting on contract performance.

Qualifications

• 3–5 years of experience in Provider Relations or related Provider Services role.
• Managed Care experience required.
• Microsoft Office Suite experience including Word, Excel, and Outlook.

Responsibilities

• Provides service and education to Network Providers.
• Contracts and renegotiates Primary Care, Specialty Physicians and Ancillary Providers across product lines.
• Collects credentialing and required documents for newly contracted providers.
• Conducts Provider Orientations and ongoing education to Network Providers.
• Understands and explains fee-for-service and risk contracts and provides reporting on contract performance.
• Manages Provider Network by developing relationships to drive regional results.
• Daily interface with providers and internal teams to resolve service issues promptly.
• Performs special projects as assigned.

Skills

Provider Relations

Managed Care

Negotiation

Communication

Analytical

Organizational

Multi-tasking

Presentation

Education and Training

Tools

Microsoft Office

Job description

COMPANY OVERVIEW

Zing Health is a tech-enabledinsurance company making Medicare Advantage the best it can be for those65-and-over. Zing Health has a community-based approach that recognizes theimportance of the social determinants of health in keeping individuals andcommunities healthy. Zing Health aims to return the physician and the member tothe center of the health care equation. Members receive individualizedassistance to make their transition to Zing Health as easy as possible. ZingHealth offers members the ability to personalize their plans, access tofacilities designed to help them better meet their healthcare needs and adedicated care team. For more information on Zing Health, visit www.myzinghealth.com.

POSITION OVERVIEW

The Provider NetworkRelations Consultant is responsible for negotiating contracts, developing, andmaintaining a cooperative relationship and an excellent rapport with allnetwork providers (including Medical Groups/IPAs, Primary Care, Specialist,Hospitals and Ancillary Providers) for an assigned region. The Provider Network Relations Consultant actsas a liaison between the network providers and Zing Health, monitoringproviders to ensure access standards are met, promoting strategic initiativesand providing training for all lines of business to ensure that networkproviders have updated policy and procedure information.

ESSENTIAL POSITIONRESPONSIBILITES

• Provides service and education to Network Providers
• Contracts and renegotiates Primary Care, SpecialtyPhysicians and Ancillary Providers for all product lines
• Collects credentialing and required documents fornewly contracted providers
• Conducts Provider Orientations and ongoing educationto Network Providers
• Understands and explains fee-for-service and riskcontracts and provides reporting on Provider and/or Service Fund performance.
• Manages Provider Network by developing andmaintaining relationships to drive business results within a specificgeographic area
• Daily interfacewith providers and internal constituents to effectively resolve service issues(contract inquires, claim issues, authorization request, eligibilityverification) in a timely manner
• Performs special projects as assigned

POSITION QUALIFICATIONS

Required Qualifications

Education/Experience

• Required 3 - 5 years ofexperience in Provider Relations, Network Development, Network Management,Contracting or related Provider Services position with demonstrated ability toperform the level of duties of the position
• Required Managed Careexperience
• Medicare experience preferred
• Other previous contractingexperience preferred
• Microsoft Office Suiteexperience - Word, Excel, and Outlook
• Excellent written andinterpersonal verbal communication skills
• Demonstrated negotiation,analytic and organizational skills
• Knowledge of healthcaredelivery a plus
• Ability to present in groupsettings, multi-task, work independently, and work within tight timeframes andmeet strict deadlines