Job Description:
Location: Candidates must be located in the state of Illinois.
The opportunity: The Provider Partner is the primary on-site point person for providers to improve their understanding of our benefit programs, policies, and procedures. The Provider Partner is responsible for provider networks regarding office education, technology promotion, network recruitment (expansion and strengthening utilization), and onboarding of newly contracted providers. The Provider Partner is also responsible for administering on-site office reviews as required by network rules and regulations.
How you will contribute:
- Maintain visibility within their market, managing their network across all product lines.
- Analyze and monitor provider cost reports on an ongoing basis to educate and improve providers' cost and quality performance.
- Actively support VBP (Value Based Pay) program.
- Responsible for recruiting new providers and maintaining network participation by providing support to dentists and dental office managers to improve their understanding of all available benefit programs.
- Responsible for educating providers, serving as the primary point of contact for instruction and advising of the comprehensive policies and procedures involving all phases of the corporation's benefits and contracts through office visits and communication over the phone and email.
- Promote dentist adoption of technology solutions by promoting web applications and increasing the volume of electronic claims.
- Seek continuous improvements by recommending changes in internal methods and procedures to the Quality Assurance process.
- Facilitate Oral Health presentations to various educational institutions and organizations.
- Represent clients and company at trade shows, health fairs, audits, dental summits, etc. throughout the designated market and/or state.
- Responsible for creation and submission of all required reports.
- Acts as a subject matter expert for their respective geographic area.
- Develop a complete understanding of the Office Reference Manuals for implementation within their region.
- Develop and continually improve personalized presentations of company benefit programs.
- Provide recommended solutions to market-related issues.
- Measure the impact of provider satisfaction (as tied to annual objectives of the team) and respond to provider issues.
- Organize and present information to providers and their staff by speaking before various provider organizations and representing the corporation in dental-related activities.
- Assist in problem resolution by identifying improvement opportunities, evaluating the feasibility of programs, and presenting recommendations when appropriate.
- Perform in-depth analysis of fee schedules, including fee schedule comparisons, to negotiate competitive custom fee schedules where needed.
- Provide regular updates to senior management on internal and external issues affecting network market performance.
- Develop and implement processes to improve overall client and provider satisfaction.
- Develop and maintain relationships with appropriate functional areas within DentaQuest to ensure effective contract performance.
- Support innovative business practices and process improvement opportunities for current and prospective clients (e.g., P4Q, QARR, ER Diversion).
- Maintain a secondary network to ensure access to care for all eligible members.
- Other duties as assigned.
What you will bring with you:
- Bachelor's Degree in Business, Healthcare Administration or related field (or relevant work experience).
- 3 years' related work experience in a healthcare environment.
- Strong presentation skills.
- Excellent verbal and written communication skills.
- Ability to work independently and as part of a team.
- Knowledge of Microsoft Office.
- Proven problem-solving skills.
- Up to 50% local travel.
- Problem solving and training experience.
- Ability to make good judgment conclusions based on data available with minimal supervision.
Preferred Qualifications:
- Dental knowledge with five (5) or more years of office experience.
- Managed Care experience.
PHYSICAL DEMANDS:
- Ability to work in a traditional professional office setting or remote equivalent.
- Ability to effectively operate computer equipment.
- Work schedule may vary and is determined by project schedules.
- Ability to travel as projects dictate.
- Ability to efficiently operate all job-related office equipment.
- Ability to communicate via telephone and work in virtual teams.
- The office environment is active with high voice levels and interruptions that may challenge hearing and concentration.
Do you see yourself in this role even if you haven't checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you.
Job Category: Sales - Client Relationship Management
Posting End Date: 26/12/2024
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