Dental Network Relations Consultant

  •  

Duluth, MN

Industry: Healthcare

  •  

Less than 5 years

Posted 177 days ago

This job is no longer available.

The Dental Network Relations Consultant (RFP and Mandates) develops and maintains positive relationships with providers and develops strategies for recruitment and contracting.

Primary duties may include, but are not limited to:

  •         Supports and manages RFP process
  •    Analyzes questions, gathering and developing responses, managing meetings
  •    Maintain RFP library
  •    Flexibility to comply with strict turnaround time to gather and distribute information which may include outside of business hours
  •    Manage product specific recruitment and tracking
  •    Improvement of policies and procedures regarding recruitment activity and tracking
  •    Interpret data, including networkdistributionreports
  •         Engage in regulatory mandates which impact networks
  •    Attend regulatory and mandate calls
  •    Ability to contribute and understand network requirements
  •    Tracking and reporting of mandated action items
  •    Strategically formulate a network recruitment guarantee and plan of action  
  •         Strategically formulate a network recruitment guarantee and plan of action
  •         Develops and maintains positive relationships with the provider community action  by periodic on-site visits, communicating administrative or programmatic changes and facilitating the resolution of provider issues.
  •         Recruits providers to build a cost effective, high quality provider network.
  •         Conducts negotiations and leads contracting efforts with providers to build and maintain a cost effective, accessible provider network.
  •         Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices.
  •         Coordinates communication process on such issues as administrative and medical policy, reimbursement and provider utilization patterns.
  •         Conducts seminars to support the understanding of managed care and Blue Cross and Blue Shield policies and procedures.
  •         Identifies network access and deficiencies and develops recruitment and contracting strategies.
  •         Coordinates and conducts provider training.

 

 

Qualifications:

Requires a BA/BS degree; 3 years of related experience (provider relations, network management, customer service, sales-negotiation); prior negotiation experience; or any combination of education and experience, which would provide an equivalent background.

 

SKILLS AND CERTIFICATIONS [note: bold skills and certification are required]

Dental 

Contracts

Mandates

RFP

Security Clearance Required: No

Visa Candidate Considered: No

COMPENSATION

Competitive Base Salary

Full-time Benefits - Full 

Relocation Assistance Available - No 

CANDIDATE DETAILS

2+ to 5 years experience

Seniority Level - Associate

Management Experience Required - No

Minimum Education - Bachelor's Degree

Willingness to Travel ? Occasionally

IDEAL CANDIDATE

Experience in contract negotiations, RFPs, mandates, negotiation experience. Dental experiencepreferred