PROVIDER ENGAGEMENT PROFESSIONAL - NETWORK DEVELOPMENT AND RELATIONS - DENTAL

Company: Humana
Location: Santa Fe
Posted on: August 30, 2024

Job Description:

Become a part of our caring community and help us put health firstThe 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.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 systemsEducate Provider Offices on all existing and new products and plansProvide support to Provider Offices on all maintenance and service issuesAssist with member/provider disputes and provide assistance to SIU and G&AAssist 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 relationshipsProvide support with new product roll-outs and assist in re-contracting effortsProcess terminations of providersAddress 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 impactRequired Qualifications2+ years of experience with Dental platformsMust be Detailed orientedProactive thought leadership/Root Cause problem resolution skillsExcellent oral and written communication skillsAbility to multi-task, manage multiple projects, and meet deadlinesDesire to learn and advanceExperience with Excel and OutlookCustomer Care/Service ExperienceStrong proficiency in relationship buildingPreferred QualificationsBachelor's DegreeExperience in Account Management3-4 years experience in Health Care industryExperience working with MTV, CBIS, QicLink, DPNMS, CRMAdditional InformationTo 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 suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates 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 informationScheduled Weekly Hours40Pay RangeThe 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 - $60,900 per yearDescription of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, 'Humana') 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 usHumana Inc. (NYSE: HUM) is committed to putting health first - 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 - 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 EmployerIt 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 Humana to 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.Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Keywords: Humana, Santa Fe , PROVIDER ENGAGEMENT PROFESSIONAL - NETWORK DEVELOPMENT AND RELATIONS - DENTAL, Healthcare , Santa Fe, New Mexico