Provider Network Representative-(Dental Contracting) - Eastern Pennslyvania

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The Provider Network Representative (Dental Recruiter) develops the Dental Provider network yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Network Contractors (Dental Recruiters) evaluate and negotiate contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsibilities also include establishing and maintaining strong business relationships with Dental Providers, and ensuring the network composition includes an appropriate distribution of provider specialties.
 
Primary Responsibilities:


Use pertinent data and facts to identify and solve a range of problems within area of expertise

Investigate non - standard requests and problems, with some assistance from others

Work exclusively within a specific knowledge area

Prioritize and organize own work to meet deadlines

Provide explanations and information to others on topics within area of expertise     

This position will be a telecommuter position with travel within the eastern half of the State of Pennsylvania to completed job function

Recruiting Dental Providers to
 

Required Qualifications:

Undergraduate degree or equivalent experience

3+ years experience in a Sales or Network Management - related role, such as contracting or provider services (preferably in the Dental space)

Knowledge of Medicare reimbursement methodologies, i.e. Resource Based Relative Value System (RBRVS)

2+ years of experience in fee schedule development using actuarial models

2+ years of experience utilizing financial models and analysis in negotiating rates with providers

At least an intermediate level of knowledge of claims processing systems and guidelines

2+ years of experience in performing network adequacy analysis
Preferred Qualifications:

Dental Provider Contracting / Services

Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information form others

Strong interpersonal skills, establishing rapport and working well with others

Strong customer service skills
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)
 
 
 
 Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
 
 UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
 
Job Keywords: network, contractor, dental, provider, RBRVS, claims, telecommute, Philadelphia, PA, Pennsylvania, Pennsylvania, Lancaster, PA, Pennsylvania, Allentown, PA, Pennsylvania, PA, Pennsylvania
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