PROVIDER NETWORK MANAGER jobs in Tampa, FL

Description

Building Brighter Futures, One Smile at a Time!

LIBERTY Dental Plan is seeking an experienced Dental Provider Network Manager for Miami-Dade County, FL.

Local Candidates ONLY, please!

The Network Manager is responsible for developing a strong provider network, recruiting, and retaining network providers, and educating provider to ensure compliance with LIBERTY’s policies and procedures. This position requires the ability to regularly travel within the Miami-Dade County, FL area during the course of work.

Job Summary Details

• Recruit General Dentists and Specialists for various networks as assigned to meet objectives at department and corporate levels.

• Review competitor information and propose strategies to meet recruitment needs.

• Analyze existing network and determine if additional recruitment of provider is necessary to meet access standards.

• Research and analyze fee schedules within assigned territory to determine cost effectiveness of contracting providers.

• Negotiate contract terms with existing and potential providers.

• Work with office staff to collect necessary contract documents for submission.

• Manage and service network providers within assigned territory according to established guidelines.

• Establish and maintain strong relationships with providers to assure stable networks.

• Work with internal and provider staff to coordinate resolution of provider and member issues.

• Assist and coordinate counseling of providers with aberrant utilization or questionable billing patterns to ensure compliance.

• Counsel providers as needed.

• Educate and train providers on policies and procedures when necessary.

• Conduct orientation according to established guidelines.

• Verify and monitor assigned network for accuracy.

• Process facility changes and submit them timely to update internal systems.

• Assist with special projects as assigned by management.

• Ensure network compliance with annual Attestation requirements.

• Conduct service calls and site visits as required by contract to ensure provider has no grievances with LIBERTY or assist with any concerns.

• Complete and review quarterly reports.

• Review necessary contract documents for accuracy & completeness for submission at Intermediate Level.

• Create and maintain DSO/Group Contracts at Intermediate Level.

• Conduct external facing communication with client management and internal facing partners at Intermediate Level.

• Performs other related duties as assigned.

Qualifications

Education/Experience

• Minimum 2 Year / Associate Degree, or equivalent combination of education and experience. Bachelors Degree preferred.
• 2 Years of previous network management experience in Dental PPO or DHMO environment, dental office management, managed healthcare, sales, and/or customer service experience.

Specific Skills/Knowledge

• Knowledge of dental terminology

• Confident Presentation skills

• Strong verbal and written communication skills in English required; bilingual a plus

• Proficient in Microsoft Office specifically Word, Excel, and Outlook. Please be prepared to complete an Online Skills Assessment as part of the Application process.

• Ability to negotiate fee schedules with providers

• Must be detail oriented, have strong customer service skills, strong organizational and time management skills at an Advanced Level

• Ability to identify problems, research issues and follow through until resolved at an Intermediate Level

• Medicaid or Medicare experience preferred

• Experience in processing provider contracts preferred

• Previous sales and customer service experience OR network management experience strongly preferred

Environmental and/ or Physical Factors

The work environment includes that required for travel from driving, to flying, to working within an office or home site location. Anticipated travel time required may vary to include an average of 50-85% of the time traveling. Work is generally performed within an office or home environment, with standard office equipment available. Employees who travel on behalf of business are required to maintain and provide auto insurance, at specified minimums. Additionally, Employees who routinely drive on Company business will have their DMV records checked periodically; Employees must maintain a safe driving record to continue driving on behalf of the Company.

Location

Our employees are distributed in office locations in multiple markets across the United States.  We are unable to hire or allow employees to work outside of the United States. This position is based out of Miami-Dade County, FL.

What LIBERTY Offers

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their society. That’s why LIBERTY offers competitive and attractive benefit packages for their employees. We strive to care for employees in positive ways that promotes wellness and productive employees.

Our first-class benefit package supports our employees and their dependents with:

• Competitive pay structure and saving options that help you reach your financial goals
• Excellent 401k retirement benefits available which includes employer match and ability to save via a Roth IRA, plus immediate vesting during Safe Harbor period and professional financial advice through Financial Engines!
• Medical insurance offered with low-cost premium for employee only coverage and LIBERTY subsidizes 50% of dependent coverage for eligible enrolled dependents.
• 100% employer paid dental coverage for employees and eligible dependents.
• 100% employer paid vision coverage for employee only coverage, low-cost premium for dependents!
• Company paid basic life and AD&D coverage; options to elect additional supplemental coverage.
• Long Term Disability coverage
• Expansive wellness program including companywide Get Active challenges and Burn-A-Long with option for gym discounts.
• Employee Assistance Program
• Generous vacation and sick leave with the ability to roll time over.
• 10 paid company holidays
• Tuition Reimbursement
• Remote or Hybrid options for various positions
• And so much more...

Compensation

In the spirit of pay transparency, we are excited to share the base salary for this position is $58,760 - $76,388, exclusive of fringe benefits or potential bonuses.  If you are hired at LIBERTY, your final base salary compensation will be determined based on factors such as geographic location, skills, education, and/or experience.  In addition to those factors – we believe in the importance of pay equity and consider internal equity of our current team members as a part of any, final offer.  Please keep in mind that the range mentioned above is the full base salary range for the role.  Hiring at the maximum of the range would not be typical in order to allow for future & continued salary growth.

LIBERTY Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. LIBERTY will leverage diverse perspectives in building high performance teams and organizational culture. 

LIBERTY Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve. 

We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.

Sponsorship and Relocation Specifications

LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.