Illinois Provider Partner Consultant, DentaQuest
Illinois Provider Partner Consultant, DentaQuest
Location: Candidates must be located in the state of Illinois.
At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you'll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America.
The opportunity:
The Provider Partner is the primary on-site point person for providers to improve their understanding of our benefit programs, policies, and procedures. The Provider Partner is responsible for provider networks with regard to office education, technology promotion, network recruitment (expansion and strengthening utilization), and onboarding of newly contracted providers.
How you will contribute:
Maintain visibility within their market, managing their network across all product lines.
Analyze and monitor provider cost reports on an ongoing basis to educate and improve providers' cost and quality performance.
Actively support VBP (Value Based Pay) program.
Responsible for recruiting new providers and maintaining network participation by providing support to dentists and dental office managers.
Educate providers, serving as the primary point of contact for instruction and advising on the comprehensive policies and procedures through office visits and communication.
Promote dentist adoption of technology solutions by promoting web applications and increasing the volume of electronic claims.
Facilitate Oral Health presentations to various educational institutions and organizations.
Represent clients and company at trade shows, health fairs, audits, dental summits, etc.
Responsible for creation and submission of all required reports.
Act as a subject matter expert for their respective geographic area.
Develop complete understanding of the Office Reference Manuals for implementation within their region.
Provide recommended solutions to market-related issues.
Measure impact of provider satisfaction and respond to provider issues.
Organize and present information to providers and their staff.
Assist in problem resolution by identifying improvement opportunities and presenting recommendations.
Perform in-depth analysis of fee schedules to negotiate competitive custom fee schedules.
Provide regular updates to senior management on internal and external issues affecting network market performance.
Develop and implement processes to improve overall client and provider satisfaction.
Develop and maintain relationships with appropriate functional areas within DentaQuest.
Support innovative business practices and process improvement opportunities.
Maintain a secondary network to ensure access to care for all eligible members.
Other duties as assigned.
What you will bring with you:
Bachelor's Degree in Business, Healthcare Administration or related field (or relevant work experience).
3 years' related work experience in a healthcare environment.
Strong presentation skills.
Excellent verbal and written communication skills.
Ability to work independently and as part of a team.
Knowledge of Microsoft Office.
Proven problem-solving skills.
Up to 50% local travel.
Ability to make good judgment conclusions based on data available with minimal supervision.
Preferred Qualifications:
Dental knowledge with five (5) or more years of office experience.
Managed Care experience.
PHYSICAL DEMANDS:
Ability to work in a traditional professional office setting or remote equivalent.
Ability to effectively operate computer equipment.
Work schedule may vary and is determined by project schedules.
Ability to travel as projects dictate.
Do you see yourself in this role even if you haven't checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you.
Life is brighter when you work at Sun Life
Excellent benefits and wellness programs.
Retirement and Stock Purchase programs.
A flexible work environment with a friendly, caring, collaborative and inclusive culture.
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.
Illinois Range: $69,400.00 - $104,100.00 USD Annual.
We consider various factors in determining actual pay including your skills, qualifications, and experience.
Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives.
At Sun Life, we strive to create a flexible work environment where our employees are empowered to do their best work.
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