Dental Provider Engagement Professional

Profile

Description

The Provider Engagement Professional 1 develops and grows positive, long-term relationships with physicians, providers and dental healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the dental health plan. The Provider Engagement Professional 1 work assignments are often straightforward and of moderate complexity.

Responsibilities

The Provider Engagement Professional 1 represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, data sharing, connectivity, documentation and coding, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

WORK STYLE: This role will be performed remotely/work from home.

WORK HOURS: Monday through Friday, 40 hours per week (8 hours per day, 5 days per week), start time must between 7AM-9AM in the employee's time zone.

Required Qualifications

2 years of healthcare or managed care with Dental Office, Provider Contracting, Network Management or Provider Relations experience

Proven planning, preparation and presenting skills

Knowledge of reimbursement methodologies and/or general knowledge of billing and claims payment methods

Demonstrated ability to manage multiple projects and meet deadlines

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Minimal travel required for trainings, conferences, and meetings

Preferred Qualifications

Bachelor's Degree

Comprehensive knowledge of Medicare policies, processes and procedures

Working knowledge of Microsoft Excel

Experience in contract fee negotiations

Additional Information

Work at Home Requirements

WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Additional Information - How We Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parental Leave

Go365 perks for well-being

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

#ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

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.

Company info

Humana Inc.
Website : http://www.humana.com