Network Relations Consultant 3

Coventry

Job Description


Mitchell, Genex and Coventry

With Mitchell, Genex and Coventry now one organization, we’ve dramatically expanded our ability to deliver innovative services and technologies to our customers. We’ve also seen career opportunities within our combined organization grow. Each part of our organization helps people recover after a challenging event in their lives.

 

Mitchell delivers trusted software and services to the property & casualty claims, collision repair and risk management industries with technology-enabled solutions that simplify claims handling, repair processes and pharmacy transactions. Genex helps injured workers return to their jobs in a safe and efficient manner through compassionate case management, reducing health care costs and disability expenses for our customers. Coventry offers the nation’s largest and most diverse set of provider and ancillary networks focused on improving total overall outcomes.

Together, we bring a complete set of proven capabilities for our partners who require more than one-dimensional solutions. We combine innovative technology, insightful analytics and deep expertise to help them reach their ultimate goal—restoring lives.


Job Description

Reviews and analyzes contracts to resolve provider disputes. Verifies system logic of various applications to ensure compliance with contract and compensation policies and procedures, parameters, and process. Examines contract performance in support of network quality, availability, and financial goals and strategies of Aetna and Coventry. Manages priority projects to ensure that a provider dispute is resolved, which may involve negotiation of settlement agreement Collaborates cross-functionally to review and resolve provider and legal issues and/or disputes. Educates and optimizes interaction with markets, providers and internal business partners to manage relationships and ensure provider needs are met. Triages and resolves escalated issues as assigned by leadership and senior leadership.


Qualifications

Required Skills and Experience: 5 + years of experience 


Benefits

We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living.
 
The Company is an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. The Company does not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.
 
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Job Requirements

 

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