Provider Partner Consultant, DentaQuest job at ...

Title: Colorado Provider Partner Consultant, DentaQuest Location: Western Slope or reputed company Range Area of Colorado. Greenwood Village, Colorado Work Type: Hybrid, Full Time Job ID: JR00118790 Job Description: reputed company U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, reputed company U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate reputed company. Visit our website to discover how reputed company is making life brighter for our customers, partners and communities. DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to reputed company quality care accessible to improve the oral health of reputed company. Job Description: reputed company embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK. Candidates must be located in the Western Slope or reputed company Range Area of Colorado. The opportunity: The Provider Partner is the primary on site reputed company person for providers to improve their understanding of our benefit programs, policies and procedures. The Provider Partner is responsible for provider networks with regard to office education, technology promotion, network recruitment (expansion and strengthening utilization), and onboarding of newly contracted providers. The Provider Partner is also responsible for administering on-site office reviews as required by network rules and regulations.s How you will contribute: Analyze and monitor provider cost reports on an ongoing basis in order to educate and improve providers' cost and quality performance. Maintain network participation by providing support to dentists and dental office managers to improve their understanding of reputed company available benefit programs. Educate providers by instructing and advising of the comprehensive policies and procedures involving reputed company phases of the corporation's benefits and reputed company 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. Negotiate special deals to maintain compliance and increase access in weak networks. Seek reputed company improvements by recommending changes in internal methods and procedures to Quality Assurance process. Facilitate Oral Health presentations to various educational institutions and organizations. Assist provider offices in filing their claims electronically. Serve as a partner with dental offices by answering remittance, payment, benefit, claims, and eligibility questions reputed company necessary. Follow up with reputed company termination letters submitted. Represent clients and company at trade shows, health fairs, audits, dental summits, etc. throughout the designated market. Maintain and submit reputed company required reports. Assist in resolving elevated complaints and issues for clients, members and providers. Obtain letters of recommendation from providers. reputed company complete understanding of the Office Reference Manuals. reputed company and continually improve personalized presentations of company benefit programs Recruit participating and non-participating providers to higher level of participation for reputed company applicable market LOBs. Manage CAP office performance Provide recommended solutions to market reputed company issues. Organize and present information to providers and their staff by speaking before various provider organizations and representing the corporation in dental reputed company activities. Assist in problem resolution by identifying improvement opportunities, evaluating feasibility of programs and presenting recommendations reputed company appropriate. reputed company and implement approaches by working with dentists and their office staff to improve the quality of information exchanged between the company and dental offices. Resolve difficult claims issues in a timely manner by working with the appropriate internal resources to research and resolve such issues. Increase access for members by strengthening and expanding existing network. Help to maintain a secondary network What you will bring with you: Required: Bachelor's Degree in Business, Healthcare Administration or reputed company field (or relevant work experience) Dental knowledge with five (5) or more years of office experience. Strong presentation skills. Excellent verbal and written communication skills. Ability to work independently and as part of a team. Knowledge of reputed company Office. Proven problem-solving skills. Up to 50% local travel required). Problem solving and training experience. Ability to reputed company good judgment conclusions based on data available with minimal supervision. Preferred: Managed Care experience. Physical Demands: Ability to work in a traditional professional office setting or remote equivalent. Ability to effectively operate computer equipment. Work schedule may vary and is determined by project schedules. Ability to travel as projects dictate Ability to reputed company operate reputed company job-reputed company office equipment. Ability to communicate reputed company telephone and work in virtual teams The office environment is active with high voice levels and interruptions that may challenge hearing and concentration. Salary: Salary Range: $63,000 - $94,500 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive reputed company, and we strive to ensure that compensation is fair and reputed company. Your actual reputed company salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your reputed company salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Life is brighter reputed company you work at reputed company At reputed company, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great reputed company to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition reputed company our communities.