Health Provider Network Consultant/Manager

$63,800 - $293,800/Yr

Accenture - Cincinnati, OH

Full-time - Mid Level

Cincinnati, OH

10,001+ employees

Professional, Scientific, and Technical Services

About the position

As a Manager/Consultant within Accenture's Healthcare Administration Consulting Practice, you will play a critical role in expanding the provider network practice, ensuring high-quality healthcare services. This position involves working with health plans, government agencies, and healthcare systems to develop effective and sustainable provider networks that enhance care delivery.

Responsibilities

• Demonstrate knowledge of vendors and solutions in the market to ensure efficient and accurate provider data for health plans.
• Analyze provider data systems to support organizational goals for compliance, access, and reporting.
• Streamline data management processes with clients to reduce errors and improve timeliness.
• Manage the contract lifecycle, 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 and Primary Source Verification (PSV).
• Advise on best practices for maintaining accurate credentialing records and meeting regulatory standards.
• Develop onboarding processes and training materials for new providers to a Health Plan.
• Lead or participate in provider network management projects to improve system processes and overall network stability.
• Mentor junior consultants and analysts, fostering a collaborative environment.

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.

Nice-to-haves

• A Master's degree
• Strong understanding of healthcare delivery systems, payer-provider relationships, and regulatory compliance.
• Proficiency in Microsoft Office Suite and provider data management software.
• Exceptional problem-solving and analytical skills.
• Strong negotiation and conflict resolution skills.
• Excellent communication and interpersonal skills.

Benefits

• Continuous learning and professional development opportunities.
• Access to a diverse and vibrant global community.
• Involvement in meaningful and innovative projects.
• Support for growing technical skills and certifications.