Provider Partner Consultant

This is a fully remote position, open to applicants in Oklahoma.

📋 Description

• Analyze and track provider cost reports to educate providers and enhance cost and quality performance.

• Assist dentists and dental office managers in comprehending benefit programs, policies, and procedures.

• Provide education to providers through in-office visits, phone calls, and email correspondence.

• Advocate for technology solutions, web applications, and electronic claims processing.

• Negotiate unique agreements to ensure compliance and improve access in underperforming networks.

• Suggest enhancements to internal methods, procedures, and Quality Assurance processes.

• Conduct oral health presentations for educational institutions and organizations.

• Support provider offices with electronic claims submission.

• Address inquiries related to remittance, payments, benefits, claims, and eligibility.

• Follow up on provider termination notices.

• Represent clients and the company at trade shows, health fairs, audits, and dental summits.

• Maintain and submit necessary reports.

• Resolve complex complaints and issues for clients, members, and providers.

• Recruit providers and enhance participation across relevant market lines of business.

• Oversee CAP office performance and propose solutions to market challenges.

• Organize and deliver information to providers and staff.

• Identify opportunities for improvement, assess program feasibility, and provide recommendations.

• Enhance information exchange between the company and dental offices.

• Resolve challenging claims issues using internal resources.

• Strengthen and broaden provider networks while maintaining a secondary network.

⛳️ Requirements

• Bachelor's Degree in Business, Healthcare Administration, or a related field, or equivalent work experience.

• Three years of relevant work experience in a healthcare setting.

• Strong skills in presenting information.

• Excellent communication skills, both verbal and written.

• Ability to work independently as well as collaboratively within a team.

• Proficiency in Microsoft Office.

• Demonstrated problem-solving abilities.

• Up to 50% local travel may be required.

• Experience in problem-solving and training.

• Capability to make sound judgments based on available data with minimal oversight.

• Dental knowledge with five or more years of office experience is preferred.

• Experience in Managed Care is preferred.

🏝️ Benefits

• Discretionary annual incentive award based on individual and business performance.

• Generous vacation and sick leave.

• Paid family, parental, and adoption leave.

• Medical insurance coverage.

• Company-paid life and AD&D insurance.

• Disability programs.

• Partially funded sabbatical program.

• 401(k) employer matching.

• Stock purchase options.

• Employer-funded retirement account.

• Flexible, inclusive, and collaborative work environment.

• Support for career growth.

• Reasonable accommodations for qualified individuals with disabilities or special disabled veterans.