Provider Engagement Manager
Sun Life
full-time
Posted on:
Location: California • 🇺🇸 United States
Visit company websiteSalary
💰 $63,000 - $94,500 per year
Job Level
Mid-LevelSenior
About the role
- Maintain network participation by providing support to dentists and dental office managers to improve their understanding of all available benefit programs
- Educate providers by instructing and advising of the comprehensive policies and procedures involving all phases of the corporation’s benefits and contracts through office visits and communication over the phone and email
- Promote dentist adoption of technology solutions by promoting Web applications and increasing the volume of electronic claims
- Recruit non-participating providers within cost and access goals
- Negotiate special deals to maintain compliance and increase access in networks
- Recommend changes in internal methods and procedures to Quality Assurance process
- Vendor relationship management for provider-facing technologies
- Facilitate Oral Health presentations to various educational institutions and organizations
- Assist provider offices in filing their claims electronically
- Serve as a liaison with dental offices by answering remittance, payment, benefit, claims, and eligibility questions when necessary
- Follow up with all termination letters submitted
- Represent clients and company at health fairs, audits, dental summits, etc. throughout your designated market
- Maintain and submit all required reports
- Netminder management
- Assist in resolving elevated complaints and issues for clients, members and providers
- Provider electronic file maintenance
- Coordinate and implement appropriate performance management strategies for team members including hiring, training, motivating, evaluating effectiveness, and assisting in performance and wage evaluations
- Responsible for attendance and company approved time off for team members
- Participate in the determination and implementation of Performance Improvement Plans and performance management initiatives
- Other duties as assigned
Requirements
- 5 years' experience in healthcare practice or managed care environment
- 3 years' supervisory/management experience
- Bachelor's degree in Business, Healthcare Administration (or related field) or equivalent, relevant experience
- Strong presentation skills
- Excellent verbal and written communication skills
- Ability to work independently and as part of a team
- Knowledge of Microsoft Office
- Proven problem-solving skills
- Problem solving and training experience
- Ability to make sound judgment conclusions based on data available with minimal supervision
- Up to 25% travel required (primarily local)
- Individuals must be located in the Western region of the United States (contiguous states plus AK)