Elevance Health · 1 day ago
Provider Relationship Account Consultant
Chicago, IL
Full-time
Onsite
Entry, Mid Level
$64K/yr - $96K/yr
2+ years expElevance Health is a health company dedicated to improving lives and communities. The Provider Relationship Account Consultant will provide quality service to the provider community, leveraging data-driven insights to enhance Payment Integrity outcomes through positive relationship management and issue resolution.
Health CareHealth InsurancePersonal HealthWellness
Responsibilities
Develops and maintains positive provider relationships with provider community via a mixture of email, telephonic and/or face-to-face outreach, by communicating administrative and programmatic changes, facilitating provider education and the resolution of provider issues
Collaborates with internal matrix partners to triage issues and submit work requests
Generally assigned to a portfolio of providers within a defined cohort
Researches, analyzes, and coordinates prompt resolution to provider issues and appeals through direct contact with providers and internal matrixed partners while interpreting provider performance scorecards to identify root causes and recommend targeted interventions
Coordinates communication process on such issues as administrative and medical policy, reimbursement, and provider utilization patterns
Conducts routine outreach to support the understanding of managed care policies and procedures, as well as outreach on a variety of initiatives and programs: focused on reducing administrative waste, improving documentation accuracy, and supporting digital tool adoption, while tracking the impact of provider engagement on medical savings, recovery cycle times, and compliance metrics. Said work will support identifying opportunities to refine audit selection criteria or engagement strategy based on observed trends
Coordinates and conducts provider training including developing and distributing provider relations materials
May assist with Annual Provider Satisfaction Surveys, required corrective action plan implementation and monitoring education and non-routine claim issues
May coordinate Provider Manual updates/maintenance
Identifies and reports on provider utilization patterns which have a direct impact on the quality-of-service delivery
Research issues that may impact future provider contract negotiations or jeopardize network retention
Qualification
Required
Requires a bachelor's degree
A minimum of 2 years of customer service experience including 1 year of experience in a healthcare or provider environment
Any combination of education and experience, which would provide an equivalent background
Preferred
Experience with data interpretation, provider performance analytics, or payment integrity programs is strongly preferred
Ability to interpret patterns and insights from complex data sets and translate them into strategic, actionable plans for engaging providers is strongly preferred
A self-starter who is highly organized, able to work independently, and capable of driving strategy from analysis through execution is strongly preferred
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
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
Elevance Health is an integrated whole-health approach to help people in health journey and address their full range of needs.
10001+ employees
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)
Funding
Current Stage
Public CompanyTotal Funding
unknown2001-10-30IPO
Leadership Team
Gail K. Boudreaux
President and CEO
Geeta Wilson
Chief Technology Officer (CTO): Digital Health and Service Experience Platforms
Recent News
2026-01-16
2026-01-12
2026-01-11
Company data provided by crunchbase