Provider Engagement Professional – Network Development and Relations
Job Description
About the Role
Title: Provider Engagement Professional – Network Development and Relations – Dental
Location: Louisville United States
Job Description:
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 â 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 âeasy to do business withâ environment for the providers is a key function of this role.
Work with DSO & 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
Address provider concerns and overcome objections with the goal of network retention.
Work with private offices & large group partners on credentialing and re-credentialing.
Address provider concerns and overcome objections with the goal of network retention.
Collaborate with both internal and external teams (including consultants) to find solutions for providers in assigned territory.
Single point of contact for all dental offices and consultants who represent them, ranging from individual practice to large groups, within assigned territory.
Reviews, assesses, and develops consultant outreach strategies based on available information and provides consistent communication of goals and outcomes.
Leads the development, implementation, and execution of content during consultant quarterly meetings, education forums and other provider-related engagement activity for consultants.
Use your skills to make an impact
Required Qualifications
2+ years of experience with Dental platforms
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 advance
Experience with Excel and Outlook
Customer Care/Service Experience
Strong proficiency in relationship building
Preferred Qualifications
Bachelor’s Degree
Experience in Account Management
3-4 years experience in Health Care industry
Experience working with MTV, CBIS, QicLink, DPNMS, CRM
Additional Information
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
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, education, certifications, etc.
$44,200 â $60,900 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, âHumanaâ) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first â for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health â delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
