Dental Provider Contract Recruiter, DentaQuest
Dental Provider Contract Recruiter, DentaQuest
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$ 70600 - 105900
1 Vacancy
Job Description
Sun Life U.S. is one of the largest providers of employee and government benefits helping approximately 50 million Americans access the care and coverage they need. Through employers industry partners and government programs Sun Life U.S. offers a portfolio of benefits and services including dental vision disability absence management life supplemental health medical stop-loss insurance and healthcare navigation. We have more than 6400 employees and associates in our partner dental practices and operate nationwide.
DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based cost-effective solutions are designed for Medicaid and CHIP Medicare Advantage small and large businesses and individuals. With a focus on prevention and value we aim to make quality care accessible to improve the oral health of all.
Job Description:
Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work.
The opportunity:
This role is responsible for managing all aspects of network contracting and reimbursement to assure a highly efficient network in accordance with the cost and quality requirements and guidelines within the program administration. The representative is responsible for building long-term relationships with provider offices and clients and negotiating on all provider contracting elements reimbursement structure technology promotion and access to care. The role is responsible for provider negotiation contracting and credentialing for all products including Medicaid Medicare Advantage Marketplace and Direct to Consumer Commercial and any blend of dental products. Negotiations and contract execution needs to take place with decision makers at the provider entities including CEOs Vice Presidents and other executive leadership at the provider offices as well as individual dentists depending on the office size location and corporate entity.
How you will contribute:
Solicit and represent the DentaQuest brand to the provider community including the potential network of providers and dental groups in assigned markets.
Effective negotiation of provider contracts and reimbursement.
Negotiate complex financial models including incentive programs capitation or special deal contracts to maintain compliance and increase cost effectiveness and access to care as necessary.
Research competition in market and make recommendations to meet or exceed competition.
Build and maintain relationships with organized dentistry and other key stakeholders.
Create and lead presentations to dental advisory groups and other stakeholder organizations.
Obtain letters of recommendation from provider entities and individual providers that partner on pilot programs efficiency projects and innovative solutions to effectively boost RFP responses and competitive positioning.
Continuous improvement on credentialing and contracting workflow process.
Ensure reports on status of providers are prepared accurately and distributed timely.
Provide recommended solutions to improving provider satisfaction.
Provide leadership and education to provider offices in filing credentialing apps electronically and support enrollment of EFTs and electronic EOBS.
Provide web portal training and support to providers for effective contracting and credentialing requirements.
Resolve escalated issues in a timely manner by working with the appropriate internal partners to ensure provider satisfaction and growth commitments from the network.
Develop and continually improve personalized presentations of company benefit programs and innovative solutions.
Recruit and contract participating and non-participating providers to higher levels of participation with additional products and improved business models.
Assist in problem resolution by identifying improvement opportunities evaluating feasibility of programs and presenting recommendations when appropriate.
Support the increase of access for members by strengthening and expanding existing network.
Adhere to DentaQuest business processes.
Other duties as assigned.
What you will bring with you:
Required Qualifications:
Bachelors Degree in Business Health Care Administration (or relevant field) or equivalent work experience.
5 years minimum heath care contracting medical and/or hospital contracting or equivalent sales experience.
Strong presentation negotiation organization analytic and presentation skills.
Demonstrated relationship building/negotiation experience
Ability to work remotely with minimal supervision.
Excellent verbal and written communication skills.
Ability to work independently and as part of a team.
Proficiency in Microsoft Office products (Excel Word & PowerPoint)
Ability to meet multiple deadlines and to prioritize and organize multiple tasks with tight deadlines.
Ability to work in high-pressure environment with tight deadlines for results
Up to 10% - 20% travel
Preferred Qualifications:
Masters degree.
Strong knowledge of Dental Provider reimbursement models and contracting. Ability to understand provider performance and costs data for effective negotiating.
Salary:
Salary Range: $70600 - $105900
At our company we are committed to pay transparency and equity. The salary range for this role is competitive nationwide and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills qualifications experience education and geographic location. In addition to your base salary this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
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We are committed to fostering an inclusive environment where all employees feel they belong are supported and empowered to thrive. We are dedicated to building teams with varied experiences backgrounds perspectives and ideas that benefit our colleagues clients and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life we prioritize your well-being with comprehensive benefits including generous vacation and sick time market-leading paid family parental and adoption leave medical coverage company paid life and AD&D insurance disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match stock purchase options and an employer-funded retirement account. Enjoy a flexible inclusive and collaborative work environment that supports career growth. Were proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S. weve also been recognized as a Top 10 employer by the Boston Globes Top Places to Work for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans unless the accommodation would impose an undue hardship on the operation of our business. Please email to request an accommodation.
For applicants residing in California please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of applicable state and local laws including applicable fair chance ordinances.
All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or status as a protected veteran.
Job Category:
Posting End Date:
Employment Type
Full-Time
