Network Relations

Job Description

Frontline of Network Development, responsible for providing excellent customer service while impacting and overseeing provider data integrity. This individual must combine strong interpersonal skills with an aptitude in the medical provider market.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Assist Developer with implementing medical providers through use of correspondence and telephonic contact

Verify all provider signatures, contracts and documentation after submitting for internal processing

Review credentials of prospective providers to be considered for acceptance into network per national credentialing requirements and protocols

Provide orientation on managed care procedures and establish liaison(s) with all participating providers

Assist and communicate a provider orientation program in cooperation with Developer

Distribute and maintain provider manual and orientation materials per state guidelines

Receive and resolve all disputes involving provider contract and payment issues in accordance with contract Dispute Resolution Procedures

Provide assistance and be responsive to staff requests for assistance, information regarding the network, both locally and nationally

Oversee distribution of executed contracts and maintenance of database

Assist with network marketing, employer and payor relations and product development

Conduct and manage provider data audits that ensure data integrity for network and oversee all provider updates and changes with NDB

Coordinate and process provider roster updates at least annually or as otherwise required

Perform facility site surveys as needed per credentialing requirements or state guidelines

Identify anemic specialties within network and generate a recruitment list for Developer

Requires regular and consistent attendance

Maintain a professional appearance

Additional duties as assigned

KNOWLEDGE & SKILLS:

Strong interpersonal skills and adaptive communication style, complex problem solving skills, drive for results, innovative

Ability to continually adapt daily routines that allow each function to be manageable

Ability to properly prioritize and manage assignments, scheduled or unscheduled

Ability to embrace new tools and procedures per corporate guidelines and objectives

Strong organizational skills

Excellent written and verbal communication skills

Superb attention to detail and ability to deliver results in a fast paced and dynamic environment

EDUCATION & EXPERIENCE:

Associate’s degree or two or more years equivalent work experience

Proficient in Microsoft applications

Customer service education/training within the insurance industry, managed care or related field

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $15.98 - $25.69 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers Opportunities in Risk Management

About CorVel

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.