The Network Manager or "Provider Relations Representative" will be responsible for developing a strong provider network, recruiting / contracting dental providers to our insurance plan, and training / educating providers to ensure compliance with LIBERTY’s policies and procedures. This position requires the ability to regularly travel in the course of work. ***Territory will cover the state of Hawaii (including Oahu).
- Recruit General Dentists and Specialists for various networks as assigned to meet objectives at department and corporate levels
- Build and maintain effective professional relationships with providers
- Provide support to Corporate and Account Management with local clients
- Attend meetings with clients and agencies, upon request
- Review competitor information and propose strategies to meet recruitment needs
- Analyze reports on existing groups and providers and determine if additional recruitment of providers is necessary to meet client access standards
- Research and analyze fee schedules within assigned territory to determine cost effectiveness of contracting providers
- Counsel providers with aberrant utilization or questionable billing patterns to ensure compliance
- Educate and train providers on policies and procedures when necessary
- Work with offices to collect necessary contract documents and follow up with providers on missing documents
- Conduct on-site structural audits and orientations according to established guidelines
- Establish and maintain strong relationships with providers to assure stable networks
- Assist offices with claims issues, grievances and other contract-related issues
Education and/or Experience:
- Experience recruiting / contracting providers to an insurance plan (provider network development) OR dental office experience OR experience with FQHCs (Federally Qualified Health Centers)
- 3+ years of experience working for a dental office, insurance plan, OR healthcare company
- Previous sales and customer service experience strongly preferred
- Knowledge of dental terminology preferred
- Strong presentation skills
- Ability to negotiate fee schedules with providers
- Strong verbal and written communication skills
- Proficient in Microsoft Office (Word, Excel and Outlook)
- Minimum typing speed of 40 wpm
- Must be detail-oriented
- Strong customer service skills
- Strong organizational and time management skills
- Ability to analyze data and solve problems
- Ability to identify problems, research issues and follow through until resolved
- Must have a valid driver’s license and proof of insurance with minimum liability of $100,000 of coverage
- Must have reliable transportation. Position requires travel by car, which may include nights and weekends for special events.
Environment and/or Physical Factors:
The work environment includes that required for travel from driving, to flying, to working within an office or home site location. Anticipated travel time required may vary to include an average of up to 25% of the time traveling. Work is generally performed within a home environment, with standard office equipment available.
Sponsorship and Relocation Specifications:
LIBERTY Dental Plan is an Equal Opportunity Employer.
No relocation assistance or sponsorship available at this time.