Provider Relations Rep / Network Manager - Tampa, Florida
LIBERTY Dental Plan
57 reviews
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Tampa, FL 33615
LIBERTY Dental Plan
57 reviews
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The Network Manager or "Provider Relations Representative" will be responsible for developing a strong provider network, recruiting and retaining network providers, 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.
• Recruit General Dentists and Specialists for various networks as assigned to meet objectives at department and corporate levels
• Review competitor information and propose strategies to meet recruitment needs
• Analyze existing network providers and determine if additional recruitment of providers is necessary to meet access standards
• Research and analyze fee schedules within assigned territory to determine cost effectiveness of contracting providers
• Manage and service network providers within assigned territory according to established guidelines
• 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 audit and orientation according to established guidelines
• Process facility changes and submit them timely to update internal system
• Establish and maintain strong relationships with providers to assure stable networks
• Complete monthly activity reports and provide updates on various recruitment projects as assigned
• Assist offices with claims issues, grievances and other contract-related issues
Qualifications
Education and/or Experience:
• Experience recruiting or contracting providers to an insurance plan
• 3+ years of healthcare company experience, dental strongly preferred
• Previous sales and customer service experience preferred
• Experience with FL Medicaid Dental preferred
• DSO and/or IPA experience preferred
Specific Skills/Knowledge:
• Knowledge of dental terminology
• Strong presentation skills
• Strong verbal and written communication skills
• Proficient in Microsoft Office (Word, Excel and Outlook)
• Minimum typing speed of 40 wpm
• Ability to negotiate fee schedules with providers
• Must be detail-oriented
• Strong customer service skills
• Strong organizational and time management skills
• Ability to analyze data and solve problems
• Ability to 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 50-75% of the time traveling. Work is generally performed within an office environment, with standard office equipment available.
Sponsorship and Relocation Specifications:
LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled.
No relocation assistance or sponsorship available at this time.