Medica · 1 day ago
Provider Network Consultant II
St Louis, MO
Full-time
Hybrid
Mid Level
$51K/yr - $76K/yr
3+ years expMedica is a nonprofit health plan serving communities in several states. The Provider Network Consultant develops and maintains provider relationships, manages ongoing provider needs, and ensures accurate provider data.
Health CareMedical
No H1B
Responsibilities
Develops and maintains assigned provider relationships
Reviews provider requests for inclusion in assigned territories and assists in analyzing impact to determine approval
Manages on-going provider needs relative to program roll-outs and medical policy change communication
Provides onboarding education/outreach, handles provider appeals, and resolves escalated provider issues
Ensures that provider data is accurate
Qualification
Required
Bachelor's degree or equivalent experience in related field
3 years of health plan or provider experience
Advanced level Microsoft Excel skills
Strong attention to detail
Aptitude to learn multiple systems
Strong written and verbal communication skills with a proven track record of follow-up
Problem solving and research skills
Preferred
Experience with claims operations and various reimbursement methodologies strongly preferred
Experience managing and loading provider rosters preferred
Benefits
Competitive medical
Dental
Vision
PTO
Holidays
Paid volunteer time off
401K contributions
Caregiver services
Many other benefits to support our employees
Company
Medica
Medica is a company that provides health coverage to meet customers needs for health plan.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
John Naylor
President and CEO
Jeni Alm
Vice President, Provider Partnerships and Solutions
Recent News
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2025-12-13
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2025-11-24
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