Dental Provider Recruiter

4 weeks ago

Long Beach, California, United States Dental Health Services Full time
Job Summary

The Provider Contract Recruiter (Network/Sales) is a critical member of the network development team, responsible for cultivating new and existing relationships with large and small dental organizations, as well as with internal business partners in our company.

This role 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.

Key Responsibilities
  • Recruit providers, including general dentists and specialists, in their given territory.
  • Evaluate and audit dental provider offices and operations, making recommendations for providing optimal service to Company members and addressing/resolving provider concerns or issues.
  • Work in partnership with Professional Services management regarding the addition or deletion of provider contracts and coordinate the termination of territory dentists.
  • Orient and train general and specialist providers on Company plans and materials, quality standards and expectations, etc.
  • Update Company data systems, including ACT, Website, Aldera, various directories, and PICK systems, to ensure accuracy of provider information.
  • Prevent/resolve Member Service concerns and issues regarding the delivery of dental services and work to resolve grievances with appropriate personnel.
  • Develop all required reporting in an accurate and timely manner.
  • Assist in the development of marketing materials for prospective and current providers.
  • Assist with DMHC, OIC, OID audits.
  • Effectively grow and maintain a provider network in assigned territory and efficiently and completely support dental providers and specialists.
  • Resolve provider/member issues, effectively addressing inquiries to the satisfaction of all parties.
  • Effectively work with team members across the company to accomplish projects and performance goals.
  • Maintain a high level of integrity and appropriate confidentiality in all activities and efforts.
  • Address and resolve a wide variety of basic to moderately complex provider and network issues and problems.
  • Support improvements in processes, programs, productivity, and services.
  • Compile and analyze competitor information and internal data to determine network needs, grow enterprise networks to remain competitive and compliant with state and federal regulations; evaluate and determine the cost-effectiveness of contracting each dental organization, balancing the needs of the dental organization with those of the business.
  • Develop a deep understanding of dental organization business plans as they relate to the maintenance and growth of our networks, allowing for creative solutioning that benefits both the dental organization and the company.
  • Interact professionally with dental organizations, including with Executives at the corporate level and with staff at individual practice locations.
  • Represent the enterprise as the point of contact for multiple dental organizations and conduct training, including contract completion and Provider Tools functions.
  • Create effective presentations and conduct impactful reviews that help dental organizations understand the values of network participation and partnered growth with our enterprise networks.
  • Effectively negotiate with dental organization Executives and internal stakeholders, utilizing excellent consultative selling and negotiation skills with the ability to influence decision-makers.
  • Monitor utilization patterns of dental organizations, interpret statistics, and recommend efficiency tools to facilitate effective plan administration.
  • Resolve concerns timely, and bring 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.
  • Partner 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.
  • Participate on assigned committees and meetings to provide ongoing feedback using market conditions, industry trends, and insights.
  • Perform any and all additional duties as requested and directed for this position.

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