Provider Engagement Professional
About The Position
The Provider Engagement Professional 1 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 a key function of this role.
Requirements
- 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
Nice To Haves
- Bachelor's Degree
- 3-4 years' experience in Health Care industry
- Experience working with MTV, CBIS, QicLink, DPNMS
- Experience with Dental Codes
Responsibilities
- Work with DSO and large group partners on credentialing and re-credentialing projects.
- Work with claims unit to identify and assist in 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 provide assistance to SIU and G&A
- Assist Provider Offices/Rental Partners with any contract issue.
- Work proactively 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 assist in re-contracting efforts
- Process terminations of providers
Benefits
- medical
- dental
- vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
