Health Provider Network Consultant/Manager

Accenture - Overland Park, KS

Full-time - Mid Level

Overland Park, KS

10,001+ employees

Professional, Scientific, and Technical Services

About the position

The position involves managing provider data systems and processes within healthcare organizations to ensure compliance, accuracy, and efficiency. The role requires collaboration with clients to streamline data management, optimize contracts, and improve onboarding workflows for healthcare providers. It also includes mentoring junior team members and contributing to internal knowledge sharing.

Responsibilities

• Demonstrate knowledge of vendors and solutions in the market to create efficient 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.
• Familiarize with the contract lifecycle management process, including negotiations and contract management with healthcare providers.
• Provide insights on reimbursement models and advise on contract optimization strategies.
• 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.
• Develop onboarding processes and training materials related to onboarding new providers to a Health Plan.
• Lead or participate in provider network management projects aimed at improving system processes, provider experience, 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.
• Mentor junior consultants and analysts, fostering a collaborative and growth-oriented environment.
• Stay informed about provider network trends, regulatory changes, and technology advancements.

Requirements

• Bachelor's degree in Healthcare Administration, Business, or a related field.
• A minimum of 3 years of experience in provider network management, healthcare contracting, healthcare operations, or related roles.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and provider data management, credentialing and contracting software.
• Exceptional problem-solving and analytical skills.
• 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.

Nice-to-haves

• A Master's degree.
• Strong understanding of healthcare delivery systems, payer-provider relationships, and regulatory compliance.
• Leadership experience and proven ability to manage multiple priorities in a fast-paced environment.

Benefits

• Continuous learning and professional development opportunities.
• Access to training resources and mentoring.
• Participation in meaningful and innovative projects powered by the latest technologies.