Provider Relations Representative

Compensation

: $58,640.00 - $91,430.00 /year *

Employment Type

: Full-Time

Industry

: Advertising/Marketing/Public Relations



Loading some great jobs for you...





MCNA Dental, a leading dental manangement administrator is seeking a Provider Relations Representative. The candidate will be responsible for maintaining working relationships with the existing Provider Network. Provides training and education regarding policy and procedures and covered benefits. Provides ongoing support for any issues. May assist with Network Development as needed.


Responsibilities:


Assists in the implementation of the Provider Relations Department processes, provider education programs and overall network functions

Works with the management team to develop and revise the Provider Manual. Assists in ensuring that the manual meets operational, regulatory, and accreditation requirements

Carries out the site review process (for credentialing and re-credentialing), provider manual documentation for education and training, referral and authorization procedures, and department activities

Serves as a mode of communication to provider offices

Assists in meeting organizational goals and objectives

Acts as the liaison between the provider groups and the plan

Carries out methods of communication to the providers for changes, revisions, issue resolution, and general notices/updates from the plan

Attends Provider Relations meetings to determine network access and availability, and meeting the requirements for ongoing membership needs

Assists with network publication, reports, updates, revision, analysis, and reporting to appropriate internal staff and the Dental Management Committee

Provides provider training and education manual and processes, documentation, reviews

Other plan required duties and responsibilities as deemed necessary and appropriate



Job Requirements:

Minimum Qualifications:

High School Diploma or GED required

Bachelors Degree in any related field preferred

At least two years customer service experience required

Experience in Medicaid managed care preferred

Bilingual or Trilingual preferred (English/Spanish or English/Spanish/French Creole)

Knowledge and Skills :

Proficiency in Microsoft Office (PowerPoint, Excel, Word)

Excellent oral and written communication skills

Effective analytical problem solving skills

Ability to travel extensively

Ability to deliver presentations (Provider training/education)

Ability to foster positive, productive working relationships

Ability to conduct self in an acceptable, professional manner and adhere to ethical standards and confidentiality requirements


This is a full time position with a competitive salary based upon experience and qualifications. Some of the benefits MCNA offers are medical, dental, vision, company paid life insurance, critical illness, accidental and other supplemental coverages, 401k, as well as paid vacation, sick and holiday time.


MCNA is an Equal Opportunity Employer -----M/F/D/V

Please check out our website: www.mcna.net


*This positions allows for telecommuting*

It s a great day at MCNA!'


* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

Launch your career - Create your profile now!

Create your Profile

Loading some great jobs for you...