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Provider Engagement Professional - Network Development and Relations-Dental

Humana

RemoteRemote NationwideMidH-1B sponsor company
Sign in to applyVerified 4d ago
Location
Remote Nationwide
Work model
Remote
Level
Mid
H-1B history
130 approvals (FY2023)
Posted
5d ago

About this role

Become a part of our caring community The Provider Engagement Professional - Network Development and Relations-Dental develops and grows positive, long-term relationships with the provider network to support and improve financial and quality performance within the contracted working relationship with the health plan. 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 an important function of this role. Work with DSO and large group partners on credentialing and re-credentialing projects. Work with claims unit to identify and support claim resolutions for providers on all systems Educate Provider Offices on all existing and new products and plans Provide support to Provider Offices on all maintenance and service issues Assist with member/provider disputes and assist SIU and G&A Assist Provider Offices/Rental Partners with any contract issue. Work with offices regarding fee schedule and financial incentive discussions. Work with Rental Partners to assure cost-saving measures have been met. Add/Term locations, associates and products to existing provider relationships Provide support with new product roll-outs and help with re-contracting efforts Process terminations of providers Use your skills to make an impact Required Qualifications 2+ years of experience with Dental platforms and/or Dental Benefits Must be Detailed oriented Proactive thought leadership/Root Cause problem resolution skills Excellent oral and written communication skills Ability to multi-task, manage multiple projects, and meet deadlines Desire to learn and grow Experience with Excel and Outlook Customer Care/Service Experience Strong Organization skills Preferred Qualifications Bachelor's Degree 3-4 years' experience in Health Care industry Experience working with MTV, CBIS, QicLink, DPNMS Experience with Dental Codes Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience,