Provider Contract Recruiter

Job Description

Job Description

You will contribute to the strength of our team approach to collaborative dental health. Do you value making an impact and doing meaningful work? Are you ready to be a difference-maker at an established independent Employee-Owned specialized healthcare company? If you enjoy working with a team of caring and dedicated people, this could be your new home Job Summary The Healthcare Business Development (Outside Sales Representative) is responsible for the growth, development and maintenance of the Company’s dental providers and provider networks. Achieves results through active prospecting, recruiting, negotiating, contracting, orienting, training, servicing and support of participating dentists and specialists in their assigned service areas. This job is a critical member of the network development team, with responsibility for cultivating new and existing relationships with large and small dental organizations, as well as with internal business partners in our company. This position assumes overall responsibility for successfully managing relationships with dental organizations as accounts, with the objective of ensuring access to care requirements are met as well as support and growth of strong, stable provider network. Essential Responsibilities Responsible for recruiting providers including general dentists and specialists in their given territory. Performs evaluations and audits of dental provider offices and operations and makes recommendations for providing optimal service to Company members and address/resolve provider concerns or issues. Works in partnership with Professional Services management regarding the addition or deletion of provider contracts and coordinates the termination of territory dentists. Orients and trains general and specialist providers on Company plans and materials, quality standards and expectations, etc. Provides updates to Company data systems including ACT, Website, Aldera, various directories and PICK systems to ensure accuracy of provider information. Prevents/resolves Member Service concerns and issues regarding the delivery of dental services and works to resolve grievances with appropriate personnel. Develops all required reporting in an accurate and timely manner. Assists in the development of marketing materials for prospective and current providers. Assists with DMHC, OIC, OID audits. Effectively growing and maintaining a provider network in assigned territory and efficiently and completely supporting dental providers and specialists. Resolving provider/member issues, effectively addressing inquiries to the satisfaction of all parties. Effectively working with team members across the company to accomplish projects and performance goals. Maintaining a high level of integrity and appropriate confidentiality in all activities and efforts. Addresses and resolves a wide variety of basic to moderately complex provider and network issues and problems. Supports improvements in processes, programs, productivity, and services. Compiles and analyzes competitor information and internal data to determine network needs, grows enterprise networks to remain competitive and compliant with state and federal regulations; evaluates and determines the cost-effectiveness of contracting each dental organization, balancing the needs of the dental organization with those of the business. Develops deep understanding of dental organization business plans as they relate to the maintenance and growth of our networks, allowing for creative solutioning that benefit both the dental organization and the company. Interacts professionally with dental organizations, including with Executives at the corporate level and with staff at individual practice locations. Represents the enterprise as the point of contact for multiple dental organizations and conducts training, including contract completion and Provider Tools functions. Creates effective presentations and conducts impactful reviews that help dental organizations understand the values of network participation and partnered growth with our enterprise networks. Effectively negotiates with dental organization Executives and internal stakeholders, utilizing excellent consultative selling and negotiation skills with the ability to influence decision-makers. Monitors utilization patterns of dental organizations, interpret statistics, and recommends efficiency tools to facilitate effective plan administration. Resolves concerns timely, and brings creative solutions, including identifying opportunities to grow and enhance services/processes to benefit all stakeholders. This includes digital adoption, as well as the promotion and management of delegated credentialing participation for dental organizations. Partners with Professional Services Coordinators and Credentialing team to monitor dental organization rosters and ensure efficient, seamless contract processing, credentialing and re-credentialing, demographic changes and terminations. Participates on assigned committees and meetings to provide ongoing feedback using market conditions, industry trends, and insights. Performs any and all additional duties as requested and directed for this position. Basic Qualifications Experience Minimum of two (2) years of related experience Education Bachelor’s degree is preferred, but candidates with a minimum of four years network recruiting, sales and/or account management experience will be considered. A minimum of three years of dental office and/or insurance administration is preferred. License, Certification, Registration Driver License and ability to maintain an acceptable Department of Motor Vehicle record Additional Requirements Knowledge of provider service operations in a dental plan member/provider environment. Knowledge of provider service principles, HIPAA, PHI and other applicable regulations and requirements in a healthcare setting. Strong written and verbal communication skills and problem-solving techniques. PC literacy required, MS Office skills. Proven track record in negotiating large, complex provider agreements, including varying compensation methodologies. Knowledge of contracting for multiple lines of business Ability to maintain consistent, regular attendance. Ability to work in a secure remote environment. Ability to travel, including overnight stays; airplane travel required. Ability to obtain and maintain sufficient credit to manage related job expenses including, but not limited to, applying to and being approved by a third-party charge card agency. Outstanding attention to detail, and strong planning and organizational skills including time management, collaboration, and business analysis skills. Ability to provide and receive constructive feedback and/or industry related feedback. Ability to maintain confidentiality and appropriately share information with discretion. Ability to operate in an environment of rapidly changing priorities. Ability to prioritize and complete multiple projects, a demanding workload, and tight timelines. Detail oriented, flexible, and creative. Skilled at working independently, demonstrated resourcefulness, and requiring little oversight. Demonstrate knowledge of Current Dental Terminology ("CDT") codes and dental nomenclature. Position Details Primary Location: Long Beach, California Job Schedule: Full time Scheduled Weekly Hours: 40 Shift: Monday - Friday between the hours of 8:00 am to 6:00 pm, Overtime as needed Travel: Yes, over 75% We look forward to having you on our team

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