Provider Solutions Consultant

Job Summary

Working remotely in a full-time capacity, the Provider Solutions Consultant will evaluate and monitor provider service performance, recommend action plans to resolve issues, and manage key provider relationships while collaborating with cross-functional teams.

Key responsibilities

• Proactively defines direction and improvement actions for Provider Solutions functions
• Identifies, triages, and prioritizes provider service issues, driving solutions based on system functionality
• Manages action plans to resolve service issues and ensures data integrity in monthly provider service scorecards

Required qualifications

• Bachelor's degree in Clinical Sciences or Business Administration, or equivalent experience
• 5 - 7 years of professional experience in operational and/or analytic processes, preferably in healthcare
• Strong understanding of Blue KC core systems and claims, reimbursement, and benefit structures
• Proficiency in Microsoft Office Suite, including Word, Excel, Access, and PowerPoint
• Demonstrated organizational, planning, and administrative skills with the ability to work under pressure