Network Consultant

1. Provider Relationship Management:

• Act as the primary contact for providers, addressing their inquiries and concerns.
• Develop and maintain strong relationships with network providers to foster cooperation and satisfaction.
• Assist providers with onboarding, training, and ongoing support.

2. Contract Management:

• Assist in the preparation, review, and management of provider contracts.
• Manage the contract renewal process and address any issues that arise.

3. Network Maintenance and Optimization:

• Maintain accurate and up-to-date provider information in the network database.
• Monitor network adequacy and identify gaps to ensure sufficient provider coverage.
• Track and report on provider performance metrics.

4. Issue Resolution:

• Identify and resolve issues related to provider claims, payments, and compliance.
• Escalate complex issues to the Provider Network Manager or other relevant departments as needed.

5. Regulatory Compliance:

• Ensure the network complies with all relevant federal, state, and local regulations.
• Assist in implementing company policies and procedures related to network management.

6. Reporting and Documentation:

• Prepare reports on provider network status, performance, and other key metrics for internal review.
• Maintain comprehensive records of provider interactions, contract negotiations, and network changes.

7. Provider Education and Training:

• Assist in the development and delivery of training programs for providers on company policies, procedures, and systems.
• Create and distribute educational materials to support provider compliance and performance.