Become a part of our caring community and help us put health first
 

The Provider Engagement Professional 1 develops and grows positive, long-term relationships with dental providers and Dental Service Organizations (DSOs) in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Professional 1 work assignments are often straightforward and of moderate complexity.

The Provider Engagement Professional 1 - Network Development and Relations-Dental works directly with our Provider Network to develop and strengthen relationships.  Educating our providers on the value of participating in the Humana Dental Network and creating a mutual professional relationship with those providers, is key to the growth of the Network.  The ability to create an “easy to do business with” environment for the providers is a key function of this role. 

• Work with DSO & large group partners on credentialing and re-credentialing projects.
• Work with claims unit to identify and assist in claim resolutions for providers on all systems
• Educate Provider Offices on all existing and new products and plans
• Provide support to Provider Offices on all maintenance and service issues
• Assist with member/provider disputes and provide assistance to SIU and G&A 
• Assist Provider Offices/Rental Partners with any contract issue. 
• Work proactively with offices regarding fee schedule and financial incentive discussions. 
• Work with Rental Partners to assure cost saving measures have been met. 
• Add/Term locations, associates and products to existing provider relationships
• Provide support with new product roll-outs and assist in re-contracting efforts
• Process terminations of providers

Use your skills to make an impact
 

WORK STYLE: Mostly remote work, with minimal travel for meetings, conferences, and/or trainings

WORK HOURS: Typical business hours (Monday-Friday, 8 hours/day, 5 days/week) in the employee's time zone, with some flexibility possible depending on business needs.

Very rarely will before/after hours, nights, weekends, holidays, or overtime be offered and will not be required.

Required Qualifications

• Experience within the dental field/industry (ie clinical experience, billing experience, front office/reception experience, sales/marketing experience, etc)

• Detailed oriented

• Proactive thought leadership/Root Cause problem resolution skills

• Excellent oral and written communication skills

• Ability to multi-task, manage multiple projects, and meet deadlines

• Desire to learn and advance

• Minimal (less than 5%) travel, for meetings, conferences, and/or trainings

Preferred Qualifications

• STRONGLY PREFERRED: Significant knowledge of Humana’s Dental & Vision platforms 

• Computer Proficiency and Experience: MTV, Excel, Power BI and Outlook, DPNMS (new internal system)

• Bachelor's Degree

• At least 3 years of experience in Health Care industry

• Customer Care/Service Experience

Additional Information

Work at Home Requirements

•    WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
•    A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.  
•    Satellite and Wireless Internet service is NOT allowed for this role.
•    A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

 

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$44,200 - $60,900 per year

 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including