Network Relations Specialist at Coventry in Wayne, Pennsylvania

Job Description:

Coventry


Network Relations Specialist

US--Remote

Job ID: 25-17835
Type: Regular Full-Time
# of Openings: 1
Category: Product & Program Management
Mitchell International, Inc.

Overview

The Enlyte Family of Businesses

Mitchell | Genex | Coventry

 

Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.

Responsibilities

This is a full time, remote position.  Candidates may reside anywhere within the U.S.

 

Join our dynamic Networks Solutions team as a Network Relations Specialist and play a crucial role in maintaining and optimizing our provider networks, ensuring seamless operations and fostering strong relationships with healthcare providers across the nation.

Your role will be instrumental in maintaining the quality, availability, and financial performance of our provider networks. In this role, you will:

• Review and analyze provider contracts to resolve disputes effectively
• Manage priority projects to ensure timely resolution of provider disputes, including negotiation of settlement agreements when necessary
• Verify system logic across various applications to ensure alignment with contract terms, compensation policies, and procedures
• Monitor and evaluate contract performance to support network quality, availability, and financial goals
• Work closely with legal, market teams, and internal business partners to review and resolve provider issues and disputes
• Educate and optimize interactions between markets, providers, and internal stakeholders to manage relationships effectively
• Triage and resolve escalated issues as assigned by leadership
• Develop and implement strategies to address complex provider concerns
• Examine contract performance metrics to support network quality, availability, and financial objectives
• Provide insights and recommendations for network optimization

Qualifications

Minimum Education:

• High School Diploma or equivalent

Required Skills and Experience:

• 2-4 years of industry-related experience
• Strong oral and written communication skills
• Familiarity with healthcare provider networks and contracting processes
• Proficiency in Microsoft Office Suite, particularly Excel

Desired Skills and Experience:

• Knowledge of Workers' Compensation and auto medical insurance
• Experience with Pricing Hub, Provider Hub, Salesforce, and/or PCM
• Ability to analyze complex data and draw meaningful conclusions
• Excellent problem-solving and negotiation skills

Salary:



Equal employment opportunity, including veterans and individuals with disabilities.

PI266493240

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