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Provider Engagement Professional (Dental)

Humana

Humana

Remote
Posted on Thursday, May 30, 2024

Become a part of our caring community and help us put health first

The Provider Engagement Professional for Dental develops and grows positive, long-term relationships with dental providers in order to support and improve financial and quality performance within the contracted working relationship. The Provider Engagement Professional works in a fast-paced environment where organization and adaptability is key!

The Provider Engagement Professional 1 - 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.
  • Work with DSO & large group on retrieval of rosters and submitting audits
  • Maintaining DSO/ large group playbook
  • 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 maintenanctemde and service issues
  • Assist with member/provider disputes and provide assistance to SIU and G&A
  • Work proactively with offices regarding fee schedule and financial incentive discussions.
  • Address provider concerns and overcome objections with the goal of network retention
  • 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
  • Single point of contact for all dental offices within assigned territory


    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 Organization skills

    Preferred Qualifications

    • Bachelors Degree
    • 3-4 years experience in Health Care industry
    • Experience working with MTV, CBIS, DPNMS
    • Experience with Dental Codes

    Additional Information

    Work at Home Requirements

    • 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 - $60,900 per year


    Description of Benefits

    Humana, 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 us

    Humana 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 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 because he or she is a protected veteran. 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.