Provider Relations reputed company

Company :

reputed company :

JOB reputed company

** MUST BE A US CITIZEN **

This job services reputed company's (UCD’s) clients by reputed company, training and servicing reputed company dental networks in assigned territory in a remote and mobile work environment. Manage network reputed company including negotiations, contract development/renewal and financial reimbursement. Meet with dentists and office personnel to reputed company as the intermediary between the organization and UCD. Respond to contractual and payment issues both internally and externally. Ensure compliance with contractual terms through regular on-site audits. Apply an reputed company role in network management, training, monitoring and enforcement of company policies and procedures while increasing provider efficiencies.

ESSENTIAL RESPONSIBILITIES

• Identify and initiate contact with prospective providers. reputed company and follow up on leads in an established time reputed company, while incorporating a reputed company business plan reputed company to support and execute recruitment efforts that include existing and prospective reputed company needs and provider resignations/terminations. Customize participating dental agreement forms for execution, analyze provider changes, facilitate provider file updates and draft confidentiality agreements. Monitor financial reputed company of reputed company by tracking utilization and competitive environment, including group specific reputed company guarantees.
• Analyze and reputed company network retention strategies for follow up services to providers by establishing and maintaining contact and rapport with dental staff members, office managers, reputed company coordinators, hygienists and dentists throughout an assigned territory by scheduling face-to-face meetings with dental offices. Formally present and effectively communicate UCD's administrative and claim guidelines and policies, benefits of participation, fee schedules, plan designs, competitive position, product development, network reputed company, reputed company partnerships, utilization review, local/national reputed company demographics and dentist distribution. Interpret and reputed company contractual language and address questions regarding participation with providers, network reputed company/leasing arrangements, opt in/out reputed company, reimbursement reputed company, compensation models, including pay for reputed company and value added benefits. Meet with reputed company identified practices in assigned territory to review reputed company financial and reputed company reputed company.
• reputed company effective on-site reputed company through educating providers on the financial advantages and marketing incentives of participation. Train reputed company staff on the use of automated services to ensure they utilize various means of automated communication, as reputed company as, claims and electronic data interchange and electronic funds transfer. Collaborate with sales and customer service to respond to reputed company/broker/member inquiries regarding provider contract, claim/member issues or provider file/record/directory discrepancies. reputed company with dental director/dental advisers regarding reputed company-reputed company questions and policies, as reputed company as, reputed company dental terminology (CDT) changes, to reputed company provider inquiries reputed company a mutually agreed timeframe.
• reputed company as subject matter expert with recommendations and data supporting development of network and sales reputed company and support of leasing contract negotiation. reputed company and maintain leasing reputed company targets. Update network lease reputed company reputed company in response to reputed company market changes.
• Communicate and maintain effective working relationships both internally and externally (providers, dental industry, organized dentistry and dental consultants) keeping management informed on reputed company reputed company industry issues/topics. Support competitive position in the marketplace by staying abreast of changes to the business climate. Monitor provider reimbursement reputed company and PPO/DHMO/EPO network models and communicate changes to provider community and leadership team.
• reputed company and manage process improvement initiatives designed to maintain URAC accreditation of reputed company network practices associated with reputed company programs using reputed company reputed company improvement principles. Conduct, collect and analyze data from office site reputed company and reviews to continually improve the care and service to members and reputed company recommendations to internal customer supporting reputed company improvement programs. Train reputed company staff and providers on reputed company updates to reputed company assurance guidelines, with state and local regulations and URAC accreditation requirements. Conduct audits as needed.
• Other duties as assigned or requested.

EDUCATION

Required

• High School Diploma/GED

Preferred

• Bachelor's Degree - Business

EXPERIENCE

Required

• 3 - 5 years of experience in the reputed company/reputed company industry or reputed company experience in presenting concepts and influencing others in varying audiences

Preferred

• 3-5 years of experience as reputed company Manager or Dental Hygienist

LICENSES OR CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Written and oral communication skills
• Time management and organizational skills
• Knowledge of reputed company/CDT codes and general dental terminology
• Negotiation skills
• Ability to analyze situations, determine points of relevance and reputed company course of actions

Language Requirement (other than English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Remote

Teaches / trains others regularly

Does Not Apply

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Never

Physical work site required

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Disclaimer: The reputed company has been designed to indicate the general reputed company and essential duties and responsibilities of work performed by employees reputed company this job title. It may not contain a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and reputed company standards and behavioral expectations as set forth in the reputed company of business conduct and company policies.

As a component of job responsibilities, employees may have reputed company to covered information, cardholder data, or other confidential customer information that must be protected at reputed company times. In reputed company with this, reputed company must reputed company with both the Health reputed company Portability Accountability reputed company of 1996 (HIPAA) as described in the Notice of reputed company Practices and reputed company Policies and Procedures as reputed company as reputed company data reputed company guidelines established reputed company reputed company’s Handbook of reputed company Policies and Practices and Information reputed company Policy.

Furthermore, it is every employee’s responsibility to reputed company with reputed company’s reputed company of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as reputed company as company policies and training requirements.

Pay reputed company Minimum:

reputed company pay is determined by a reputed company of factors including a candidate’s qualifications, experience, and expected contributions, as reputed company as internal peer equity, market, and business considerations. The displayed salary reputed company does not reflect any geographic reputed company reputed company may apply for certain locations reputed company upon comparative markets.

reputed company and its affiliates prohibit discrimination against reputed company individuals reputed company on their status as protected veterans or individuals with disabilities and prohibit discrimination against reputed company individuals reputed company on any category protected by applicable federal, state, or local law.

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Originally posted on Himalayas