Network Relations Consultant

  • 16945 Northchase Dr, Houston, TX 77060, USA
  • Employees can work remotely
  • Full-time

Company Description

HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization & care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment.

HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth.

Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp has two locations in Houston, one a corporate office and the second a state-of-the art contact center. HealthHelp is also proud to have another such contact center in Albany, New York.

WNS Global Services Inc. (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance, Manufacturing, Retail and Consumer Packaged Goods, Shipping and Logistics, Telecommunications, Travel and Utilities. Globally, the group’s over 44,000+ Professionals serve across 60 delivery centers in 16 countries worldwide.

Job Description

MAJOR RESPONSIBILITIES

The Network Relations Consultant (NRC) is responsible for developing and fostering relationships with health plan contacts, providers including physicians and staff to increase participation in HealthHelp’s UM programs. He/she builds and cultivates positive interactions with the providers and health plans to advance the goals of the HealthHelp suite of programs and promotes consistency with various provider/payer contractual obligations.

Job Responsibilities:

  • Develops, expands, and fosters long-term positive provider and market-level relationships
  • Ensures overall client and provider satisfaction with timely response to issues and questions
  • Prepares for and conducts regularly scheduled provider conference calls/meetings to address service delivery expectations, progress, planning, review of deliverables, service delivery outcomes, education regarding products, and issues resolution
  • Contacts provider regarding education and  participation in HealthHelp’s Radiology Management Services programs
  • Reviews routine and ad-hoc reports for accuracy and trends and compiles dashboards for distribution to the providers 
  • Educates providers about HealthHelp’s ever-expanding portfolio of products and services, ensuring continually updated knowledge about HealthHelp
  • Ensures providers receive appropriate education regarding HealthHelp’s processes and protocols
  • Documents all activities accurately and completely within the database/portal
  • Assists in the development of strategic initiatives to roll out new provider programs
  • Adheres to all regulatory requirements and comprehends and complies with best practices, professional standards, internal polices, and procedures
  • Performs in-house and field network-related functions, including network education, relationship building, and problem resolution
  • Works in collaboration with cross-functional teams to identify trends and assists in developing strategies to enhance client satisfaction and drives growth and expanded business for HealthHelp
  • Assists to design and/or enhances documentation, process flows, and training materials for use both internally by HealthHelp staff and externally by the provider and/or client
  • Identifies service issue trends and collaborates with cross-functional teams to develop and implement improvement plans
  • Monitors provider concerns and issues and provides feedback to the appropriate associates/departments.
  • Assists in developing and communicating the appropriate and timely response to providers and our health plan partners
  • Keeps HealthHelp leadership informed of performance, critical issues, etc.
  • Performs other duties and projects as assigned

 

Qualifications

  • Excellent listening, oral, and written communication/presentation skills with solid ability to effect people at all levels. Ability to communicate complex information in a clear and concise manner
  • Strong problem solving, interpersonal, and customer service skills
  • Demonstrates strong analytical skills in the ability to obtain, manipulate, and interpret various reports/data to produce meaningful information related to the account
  • Must be able to work in a fast-paced environment and be detailed oriented
  • Excellent oral and written communication skills and advanced presentation skills
  • Possesses familiarity with project management, implementation, and provider management processes
  • Must work effectively in a team setting and be able to interact with a variety of staff members throughout the organization; demonstrate initiative and creativity and work independently
  • Ability to prioritize and manage concurrent projects, some of which have competing priorities
  • Ability to communicate effectively with team as well as all levels of customer and senior management
  • Ability to recognize potential and actual problems while working with the team to stratigize solutions and implement an effective course of action
  • Intermediate skill level in working with the Microsoft Office Applications suite, including Outlook, Word, Excel, and PowerPoint, as well as the Internet
  • Must be able to multi-task and prioritize projects in a fast-paced environment
  • Must be able to use standard office equipment
  • Prefer Bachelors in business or health care related program or equivalent experience
  • Prefer 3 years of experience in a managed care environment
  • Proficient in MS Office Suite Applications

Additional Information

All your information will be kept confidential according to EEO guidelines.

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