Network Relations Consultant Senior (Value-Based Program Specialist) – MyCare Ohio

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Be Part of an Extraordinary Team

The MyCare Ohio Plan program is to deliver highquality trauma informed culturally competent personcentered coordination for all members that addresses physical health behavioral health long term services and supports and psychosocial needs.

Network Relations Consultant Senior (Value-Based Program Specialist) MyCare Ohio

Location: This position is based in Ohio; the associate will report to one of our 4 office locations below:

• 3075 Vandercar Way Cincinnati OH 45209

• 8940 Lyra Drive STE 300 Columbus OH 43240

• 4361 Irwin Simpson Road Mason OH 45040

• 6000 Lombardo Center STE 200 Seven Hills OH 44131

In Office Expectation: Hybrid 1; This role requires associates to be in-office 1-2 days per week fostering collaboration and connectivity while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

Shift & Hours:Monday-Friday 8:00 AM - 5:00 PM Eastern Time

The Network Relations Consultant Senior (Value-Based Program Specialist) is responsible for and is fully dedicated to delivering on the LTSS commitment to linking provider payment to improved performance. This role will support the design and modification of Anthem VBP based on stakeholder feedback and utilization.

How You Will Make an Impact

Primary duties may include but are not limited to:

• This associate will partner with Ohio Department of Medicaid (ODM) other LTSS contractors and stakeholders to support the deployment of Value Based Payment methodologies for home and community-based services and long-term care nursing facility services as well as to providers of other covered services to meet provider needs and drive quality

• In addition to advising on innovative programming for Anthem and supporting the VBPs the role will be responsible for provider training technical assistance utilization and performance monitoring related to the VBP offerings.

• Work collaboratively with stake holders to define key VBP performance indicators and deliver accurate and timely program performance to the providers as defined by program-specific requirements.

• Establish a core set of measures to be included in all provider feedback reports standardized across all LTSS Contractors issuing the feedback reports.

• May be responsible for coordinating negotiated contracts for new and existing providers as needed.

• Functions as a high-level technical resource to resolve or facilitate complex provider issues.

• Coordinates Joint Operation Committees (JOC) of larger provider groups driving the meetings in the discussion of issues and changes.

• Identifies and reports on provider utilization patterns which have a direct impact on quality-of-service delivery.

• Tracks and conduct provider refresher training as needed.

• Researches issues that may impact future provider negotiations or jeopardize network retention.

• Travels to worksite and other locations as necessary.

Minimum Requirements:

• Requires a Bachelors degree and a minimum of 5 years of customer service experience including 2 years experience as a Network Management Representative; or any combination of education and experience which would provide an equivalent background.

Preferred Skills Capabilities & Experiences:

• Prior experience as an LTSS or HCBS provider or in a provider office is preferred.

• Experience training or mentoring preferred.

• Value Based contracting/payment concepts experience preferred.

• Provider education experience preferred.

• Experience presenting to various levels of leadership strongly preferred.

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Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.

We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.