LIBERTY Dental Plan San Jose, CA, USA
Jun 17, 2018
Job Description Individual 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 Central CA region: Santa Clara, Fresno, Merced, and Monterey counties. 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 Education and/or Experience: High School Diploma required BA/BS degree preferred Previous insurance network management experience required Minimum 3 years of dental or healthcare industry experience Previous sales and customer service experience strongly preferred Specific Skills/Knowledge: Knowledge of dental terminology Strong presentation skills Strong verbal and written communication skills Proficient in Microsoft Office specifically 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 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 50-85% of the time traveling. Work is generally performed within an office or 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. Company Description Now serving over 3 million members nationwide, LIBERTY strives to provide the best customer service for not only our external customers, but our employees, who contribute to our success. LIBERTY puts people at the center of everything we do. We offer an environment where you can be challenged, pursue goals, develop and cultivate new skills. At LIBERTY, we are employee-focused and are committed to our people, their job satisfaction, their welfare, and of course, their safety.