Provider Engagement Professional - Network Development and Relations - Dental
About the position
Become a part of our caring community and help us put health first. The Provider Engagement Professional 1 develops and grows positive, long-term relationships with physicians, providers, and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Professional 1 work assignments are often straightforward and of moderate complexity. The Provider Engagement Professional - Network Development and Relations-Dental works directly with our Provider Network to develop and strengthen relationships. Educating our providers on the value of participating in the Humana Dental Network and creating a mutual professional relationship with those providers is key to the growth of the Network. The ability to create an 'easy to do business with' environment for the providers is a key function of this role. In this role, you will work with DSO & large group partners on credentialing and re-credentialing projects, collaborate with the claims unit to identify and assist in claim resolutions for providers on all systems, and educate Provider Offices on all existing and new products and plans. You will provide support to Provider Offices on all maintenance and service issues, assist with member/provider disputes, and provide assistance to SIU and G&A. Additionally, you will work proactively with offices regarding fee schedule and financial incentive discussions, ensuring that cost-saving measures have been met with Rental Partners. Your responsibilities will also include adding and terminating locations, associates, and products to existing provider relationships, supporting new product roll-outs, and assisting in re-contracting efforts. You will process terminations of providers, address provider concerns, and overcome objections with the goal of network retention. As a single point of contact for all dental offices and consultants who represent them, you will review, assess, and develop consultant outreach strategies based on available information, providing consistent communication of goals and outcomes. You will lead the development, implementation, and execution of content during consultant quarterly meetings, education forums, and other provider-related engagement activities for consultants.
Responsibilities
Develop and grow positive, long-term relationships with physicians, providers, and healthcare systems.
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Work with DSO & large group partners on credentialing and re-credentialing projects.
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Collaborate with claims unit to identify and assist in claim resolutions for providers.
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Educate Provider Offices on all existing and new products and plans.
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Provide support to Provider Offices on all maintenance and service issues.
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Assist with member/provider disputes and provide assistance to SIU and G&A.
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Assist Provider Offices/Rental Partners with any contract issues.
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Work proactively with offices regarding fee schedule and financial incentive discussions.
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Ensure cost-saving measures have been met with Rental Partners.
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Add/Term locations, associates, and products to existing provider relationships.
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Support new product roll-outs and assist in re-contracting efforts.
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Process terminations of providers.
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Address provider concerns and overcome objections with the goal of network retention.
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Collaborate with both internal and external teams to find solutions for providers in assigned territory.
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Act as the single point of contact for all dental offices and consultants within assigned territory.
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Review, assess, and develop consultant outreach strategies based on available information.
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Lead the development, implementation, and execution of content during consultant quarterly meetings and education forums.
Requirements
2+ years of experience with Dental platforms
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Detail-oriented
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Proactive thought leadership/Root Cause problem resolution skills
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Excellent oral and written communication skills
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Ability to multi-task, manage multiple projects, and meet deadlines
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Desire to learn and advance
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Experience with Excel and Outlook
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Customer Care/Service Experience
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Strong proficiency in relationship building
Nice-to-haves
Bachelor's Degree
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Experience in Account Management
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3-4 years experience in Health Care industry
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Experience working with MTV, CBIS, QicLink, DPNMS, CRM
Benefits
Medical, dental, and vision benefits
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401(k) retirement savings plan
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Paid time off including company and personal holidays
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Volunteer time off
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Paid parental and caregiver leave
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Short-term and long-term disability
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Life insurance
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Other opportunities for personal wellness and smart healthcare decisions
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