Travel: Hybrid (1-2 days onsite) 20% Travel with potential overnight as needed
How you will make an impact:
The LTSS Network Education Representative Sr is responsible for enhancing and overseeing a comprehensive initial and ongoing provider training and communication plan, ensuring the provider network has the resources, tools, and supports necessary to deliver high-quality care to members. This specialist position will demonstrate, teach, and guide external LTSS providers through customer service including training, contracting assistance, claims resolution and advocacy.
Primary duties may include, but are not limited to:
Provides/coordinates provider training for programs, services, claims and billing procedures, contract compliance and special health care needs of members
Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
Develops and provides a standard orientation package for newly contracted providers.
Promotes technology and skills development to improve provider business practices.
Supports the efficacy of contractual agreements with all providers to ensure compliance with local/state/federal regulations.
Coordinates, advertises, and tracks attendance for internal and external trainings, identifying gaps and ad-hoc training needs
Works collaboratively with Network Support, Contracting, and Credentialing associates to ensure LTSS credentialing standards are followed, maintaining accurate provider data.
Provides leadership in the development of provider education and internal health plan support to mitigate issues related to provider operations, contracting and provider claims submissions.
Mentors, coaches and trains peers. Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies.
Minimum Requirements:
Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Experience training and coaching providers on services, programs, billing, state and Federal requirements.
Experience working for and/or with LTSS/HCBS providers
Previous experience with provider education and training is very strongly preferred.
Knowledge in available Medicaid programs and resources.
Medicaid or LTSS claims experience.
Very strong written and verbal communication skills.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
