Network Education Rep Sr (US) at Elevance Health in Tampa, Florida

Job Description:

Network Education Representative Sr.




Location: Tampa FL. or Miami, Fl. This is a hybrid role with 1 - 2 days per week required in-office. Selected candidate must reside within 50 miles or one hour commute from a pulse point Elevance Health Location.



How you will make an impact:

• Supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy.


• Develops and provides a standard orientation package for newly contracted providers.


• Promotes technology and skills development to improve provider business practices.


• Provides/coordinates provider training for claims and billing procedures, contract compliance, medical management, and pharmacy issues.


• Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.


• Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations.


• Facilities provider network by recruiting necessary PCP, Specialist, Ancillary, and Hospital providers and assisting Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.


• Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies.


• Mentors, coaches and trains lower level staff.


• Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies.

• 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.

• Long term care, managed care preferred.


• Prior leadership experience preferred.


• Experience with Medicaid products preferred.


• Avality training preferred.


• Bilingual preferred.