Provider Engagement Consultant

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Grand Rapids, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.&nbsp;<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />For Application Timeline &amp; Selection Process:&nbsp;<a href="" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions.

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Competitive Total Compensation Package

Overview: Educates providers, office staff, and billing entities about current BCBSM/BCN/BCC programs, policies and procedures. Analyze financial and utilization data to develop plans to assist providers in better managing patient care. Resolves problems with providers and staff including claims, eligibility, financial, utilization, performance improvement, disease management programs, and other operational issues. Assist with the contracting of ancillary, primary, and specialty providers, hospitals and PCG&rsquo;s.
Responsibilities: <ul> <li>Represent BCBSM/BCN/BCC to the provider community through on-site visits, virtual training, fairs seminars, and other events.</li> <li>Keep abreast of BCBSM/BCN/BCC provider programs, policies and procedures in order to support education and operational initiatives.</li> <li>Resolve complex claim inquiries related to but not limited to contractual issues and interpretation. Resolve questions around operational issues.</li> <li>Support corporate performance, gain sharing, and risk management initiatives including RMRA, STARS, and HEDIS.</li> <li>Provider support for corporate projects and systematic technical implementations that directly impact the provider community.</li> </ul>
Requirements: <ul> <li>Bachelor&rsquo;s degree in business or health related field required.&nbsp;</li> <li>Three (3) years of related experience in provider servicing, customer servicing, marketing or healthcare sales required.&nbsp;</li> <li>Considerable knowledge of the health care environment&nbsp;</li> <li>Experience and understanding of BCBSM/BCN/BCC provider programs.&nbsp;</li> <li>Intermediate knowledge of Microsoft Word, Excel and PowerPoint required.&nbsp;</li> <li>Excellent customer service and interpersonal skills including the ability to interact with internal and external customers and all levels of the organization required.&nbsp;</li> <li>Excellent written and verbal communication skills including the ability to conduct presentations required.&nbsp;</li> <li>Excellent organizational skills with the ability to handle multiple project and timelines required.&nbsp;</li> <li>Knowledge of PPO/Medicaid/HMO/Managed Care Preferred.&nbsp;</li> <li>Knowledge of provider reimbursement principles preferred.&nbsp;</li> <li>Demonstrated ability to read, analyze and interpret a variety of reports, including utilization, quality and financial data.&nbsp;</li> <li>Demonstrated ability to write reports and business correspondence.&nbsp;</li> <li>Excellent public speaking skills required.&nbsp;</li> <li>Reliable transportation and the ability to work independently offsite.&nbsp;</li> <li>Valid driver&rsquo;s license.</li> </ul> <div id="gtx-trans" style="position: absolute; left: -21px; top: 26.7639px;">&nbsp;</div>