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Elevance Health · 1 day ago

Network Relations Consultant Senior (Value-Based Program Specialist) – MyCare Ohio

Columbus, OH

Full-time

Hybrid

Senior Level

$69K/yr - $103K/yr

5+ years exp

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. The Network Relations Consultant Senior (Value-Based Program Specialist) is responsible for delivering on the LTSS commitment to linking provider payment to improved performance, supporting the design and modification of Anthem VBP based on stakeholder feedback and utilization.

Health CareHealth InsurancePersonal HealthWellness

H1B Sponsor Likely

Responsibilities

This associate will partner with Ohio Department of Medicaid (ODM), other LTSS contractors, and stakeholders to support the deployment of Value Based Payment methodologies for home and community-based services and long-term care nursing facility services, as well as to providers of other covered services, to meet provider needs and drive quality

In addition to advising on innovative programming for Anthem and supporting the VBPs, the role will be responsible for provider training, technical assistance, utilization, and performance monitoring related to the VBP offerings

Work collaboratively with stake holders to define key VBP performance indicators and deliver accurate and timely program performance to the providers as defined by program-specific requirements

Establish a core set of measures to be included in all provider feedback reports, standardized across all LTSS Contractors issuing the feedback reports

May be responsible for coordinating negotiated contracts for new and existing providers as needed

Functions as a high-level technical resource to resolve or facilitate complex provider issues

Coordinates Joint Operation Committees (JOC) of larger provider groups, driving the meetings in the discussion of issues and changes

Identifies and reports on provider utilization patterns which have a direct impact on quality-of-service delivery

Tracks and conduct provider refresher training as needed

Researches issues that may impact future provider negotiations or jeopardize network retention

Travels to worksite and other locations, as necessary

Qualification

Value Based PaymentLTSS experienceProvider trainingCustomer serviceProvider educationMentoringPresentation skills

Required

Requires a Bachelor's degree and a minimum of 5 years of customer service experience including 2 years' experience as a Network Management Representative; or any combination of education and experience, which would provide an equivalent background

Preferred

Prior experience as an LTSS or HCBS provider or in a provider office is preferred

Experience training or mentoring preferred

Value Based contracting/payment concepts experience preferred

Provider education experience preferred

Experience presenting to various levels of leadership strongly preferred

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Paid Time Off

Medical, dental, vision, short and long term disability benefits

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Company

Elevance Health

Glassdoor3.6

Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.

Founded in 1944

Indianapolis, Indiana, USA

10001+ employees

https://www.elevancehealth.com

H1B Sponsorship

Elevance Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (488)

2024 (604)

2023 (660)

2022 (222)