Senior Network Relations Consultant (Value-Based Program Specialist)

Anticipated End Date: 2026-01-21

Position Title: Senior Network Relations Consultant (Value-Based Program Specialist)

Location: This position is based in Ohio; the associate will report to one of our 4 office locations below:

3075 Vandercar Way, Cincinnati, OH 45209

8940 Lyra Drive, STE 300, Columbus, OH 43240

4361 Irwin Simpson Road, Mason, OH 45040

6000 Lombardo Center, STE 200, Seven Hills, OH 44131

This role operates under a hybrid model, requiring associates to be in the office 1 - 2 days per week. This fosters collaboration while supporting productivity and work-life balance. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

Shift & Hours: Monday-Friday, 8:00 AM - 5:00 PM Eastern Time

The MyCare Ohio program delivers high-quality, trauma-informed, culturally competent, and person-centered care that addresses physical health, behavioral health, long-term services and supports, and psychosocial needs.

How You Will Make an Impact

Partner with Ohio Department of Medicaid (ODM), LTSS contractors, and stakeholders to implement Value-Based Payment methodologies for home and community-based services, as well as long-term care services.

Advise on innovative programming for Anthem and support Value-Based Programs (VBPs). Provide provider training, technical assistance, utilization tracking, and performance monitoring related to VBPs.

Collaborate with stakeholders to define key VBP performance indicators and deliver timely information on program performance to providers.

Establish a standardized set of measures for provider feedback reports across all LTSS contractors.

Coordinate contracts for new and existing providers as needed.

Act as a high-level technical resource to resolve complex provider issues.

Lead Joint Operation Committees (JOC) of larger provider groups to discuss issues and changes.

Analyze provider utilization patterns that impact quality of service delivery.

Conduct provider refresher training as needed.

Research potential issues that may affect future provider negotiations or network retention.

Travel to worksite and other locations as necessary.

Minimum Requirements:

Bachelor's degree and a minimum of 5 years of customer service experience, including 2 years as a Network Management Representative; or equivalent education and experience.

Preferred Skills, Capabilities, & Experiences:

Experience as an LTSS or HCBS provider or in a provider office.

Experience in training or mentoring.

Familiarity with Value-Based contracting/payment concepts.

Experience in provider education.

Strong presentation skills to various leadership levels.

The salary range for this position is $68,800 to $103,200 annually. Elevance Health offers a comprehensive benefits package, including incentive programs, equity stock purchase, and 401k contribution, subject to eligibility requirements.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: PND > Provider Relationship Account Management

Elevance Health only accepts resumes from agencies with a signed agreement. Any unsolicited resumes are deemed the property of Elevance Health.

Who We Are

Elevance Health is dedicated to improving lives and communities, making healthcare simpler. We seek leaders at all levels to impact our members and communities positively.

How We Work

We create a culture that advances our strategy, leading to personal and professional growth for associates. Our values and behaviors drive our success.

Elevance Health operates with a Hybrid Workforce Strategy; associates are required to work at an Elevance Health location at least once a week. Specific expectations will be discussed as part of the hiring process.

COVID-19 and Influenza vaccinations may be required for certain roles; offers may be rescinded if candidates are not vaccinated without an acceptable explanation.

Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to various protected categories. Applicants needing accommodation may contact Elevance Health for assistance.