Provider Relations Representative
DentaQuest

Responsible for managing relationships with Providers within their assigned market. As such, spends most time in the field communicating with providers about suite of benefit programs (Medicaid, Medicare Advantage, Marketplace and Direct to Consumer and Commercial and any blend of dental products), supporting the P&L of the network. Works collaboratively with reporting to understand provider reports and stressing continuous improvement to the Providers (high performance metrics, cost, outliers, quality, etc.)

PRIMARY JOB RESPONSIBILITIES:

• Maintain visibility within their market, with an eye toward managing their book of business across all product lines.
• Analyze and monitor provider cost reports on an ongoing basis in order to educate and improve providers' cost and quality performance.
• Actively support VBP (Value Based Pay) program.
• Maintain network participation by providing support to dentists and dental office managers to improve their understanding of all available benefit programs.
• Educate providers by instructing 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 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.
• Maintain and submit all required reports.
• Develop 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 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 feasibility of programs and presenting recommendations when appropriate.
• Develop and implement approaches by working with dentists and their office staff to improve the quality of information exchanged between the company and dental offices.
• Help to maintain a secondary network.
• Other duties as assigned.

Required Qualifications:

• Bachelor's Degree in Business, Healthcare Administration or related field (or relevant work experience)
• 3 years' related work experience in 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 required).
• 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.