Health Provider Network Consultant/Manager

Health Provider Network Consultant/Manager

11 Dec 2024
Arizona, Scottsdale, 85250 Scottsdale USA

Health Provider Network Consultant/Manager

Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 750,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities. Visit us at www.accenture.com . Strategy & Consulting: We work with C-suite executives, leaders and boards of the world’s leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360° stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functional expertise is supported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization’s total enterprise reinvention. As a Manager/Consultant within our Healthcare Administration Consulting Practice, you will play a critical role in expanding our provider network practice, ensuring high-quality healthcare services . Yo u will ensure that our clients—health plans, government agencies, and healthcare systems— can offer the highest quality of care delivery through an effective and sustainable provider network. The ideal candidate will have a strong background in health administration strategy, provider operations, provider contracting, provider data management, and credentialing. Your primary responsibilities may include : Provider Data Management

Demonstrate knowledge of the vendors and solutions in the market to help make efficient and accurate provider data for health plans.

Analyze provider data systems to ensure they support organizational goals for compliance, access, and reporting.

Work with clients to streamline data management processes, reducing errors and improving timeliness.

Provider Contracting

Be familiar with the contract lifecycle management process, including negotiations and contract management with healthcare providers, ensuring that terms align with organizational goals, compliance standards, and financial objectives .

Provide insights on reimbursement models and advise on contract optimization strategies.

Provider Credentialing

Understand the Provider Credentialing and Re-Credentialing process including onboarding, Primary Source Verification (PSV), and Credentialing Committee.

Advise on best practices for maintaining accurate credentialing records and meeting regulatory standards.

Evaluate and improve onboarding workflows, ensuring timely and compliant provider activation.

Provider Education & Onboarding

Develop onboarding processes and training materials related to onboarding new providers to a Health Plan, ensuring they understand organizational goals, policies, and clinical guidelines.

Project Management

Lead or participate in provider network management projects aimed at improving system processes, provider experience and coordination, and overall network stability.

Manage timelines, deliverables, and stakeholder communications to ensure successful project outcomes.

Provide regular updates and performance reports to clients, highlighting progress and areas for improvement.

Team Leadership an d Development

Mentor junior consultants and analysts, fostering a collaborative and growth-oriented environment.

Provide feedback and coaching to team members, supporting their professional development and project contributions.

Thought Leadership and Industry Engagement

Stay informed about provider network trends, regulatory changes, and technology advancements.

Contribute to internal knowledge sharing through case studies or presentations, enhancing the firm’s expertise and reputation.

Travel

As needed, up to 80%

Why should I join the Accenture Health team?    

  Innovate every day. Be at the forefront of designing and delivering health technology solutions that push boundaries and create new opportunities for our clients.    

Lead with the industry’s best . Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcare transformation to meet the diverse needs of patients and members.    

Learn and grow continuously. Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real-life client simulations and ongoing mentoring available when you need it, you’ll expand your thinking beyond the core Workday implementation.    

Here’s what you need:    

Bachelor’s degree in Healthcare Administration , Business , or a related field.

A minimum of 3 years of experience in provider network management, healthcare con tracting, healthcare operations, or related roles.

​​ Bonus points if you have:

A Master's degree

A strong understanding of healthcare delivery systems, payer-provider relationships, and regulatory compliance .

Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and provider data management, credentialing and contracting software.

Exceptional problem-solving and analytical skills.

The ability to work independently and collaboratively in a team setting.

Strong negotiation and conflict resolution skills.

Excellent communication and interpersonal skills for managing provider relationships and interacting with cross-functional teams .

Leadership experience, and proven ability to manage multiple priorities in a fast-paced environment.

What’s in it for you?You will be part of a diverse, vibrant, global Accenture community; teams pushing the boundaries of new business capabilities and emerging technologies and services, sharing their experiences and lessons learned with each other. You’ll have the chance to thrive in an environment where your ideas are valued and your voice matters.At Accenture, you will be able to work on meaningful and innovative projects, powered by the latest technologies and industry best practices such as event-driven architectures and domain driven design.Accenture will continually invest in your learning and growth. You'll learn from and work with Accenture’s certified practitioners and Accenture will support you in growing your own tech stack, sales skills, and certifications.You'll be immersed in the design and implementation of human-centric solutions to help solve complex challenges with some of the world’s largest companies.Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, District of Columbia, Illinois, Maryland, Minnesota, New York or Washington as set forth below.We accept applications on an on-going basis and there is no fixed deadline to apply.Information on benefits is here. (https://www.accenture.com/us-en/careers/local/total-rewards) Role Location Annual Salary RangeCalifornia $63,800 to $293,800Colorado $63,800 to $253,800District of Columbia $68,000 to $270,300Illinois $59,100 to $253,800Minnesota $63,800 to $253,800Maryland $59,100 to $235,000New York $59,100 to $293,800Washington $68,000 to $270,300What We BelieveWe have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment.Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities. Read more here (https://www.accenture.com/us-en/about/inclusion-diversity/us-workforce) Equal Employment Opportunity StatementAccenture is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation.All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.Accenture is committed to providing veteran employment opportunities to our service men and women.For details, view a copy of the Accenture Equal Employment Opportunity and Affirmative Action Policy Statement (https://www.accenture.com/content/dam/accenture/final/accenture-com/document/Annual-Policy-Statement-Regarding-EEO-2023-Applicant.pdf#zoom=50) .Requesting An AccommodationAccenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.If you would like to be considered for employment opportunities with Accenture and have accommodation needs for a disability or religious observance, please call us toll free at 1 (877) 889-9009, send us an email (https://www.accenture.com/us-en/about/contact-us) or speak with your recruiter.Other Employment StatementsApplicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.

Related jobs

Job Details

Jocancy Online Job Portal by jobSearchi.