What are the responsibilities and job description for the Dental Provider Engagement & Network Operations Specialist, Senior position at CareOregon?
Career Opportunities : Dental Provider Engagement & Network Operations Specialist, Senior (24734) Requisition ID 24734 - Posted 12 / 06 / 2024 - CareOregon - Full Time - Permanent - Portland - Multi Location (2) Job Description Print Preview If you receive an offer of employment for this position, it is contingent on the satisfactory completion of a pre-employment background check, immunization review, and drug screen (including THC / Marijuana). CareOregon is a federal contractor and must comply with all federal laws. Job Title Dental Provider Network Operations and Engagement Specialist, Senior Exemption Status Exempt Management Level n / a Direct Reports n / a Manager Title Director, Oral Health Clinical Services Department Dental Requisition 24734 Pay & Benefits Estimated hiring range $71,340 - $87,200 / year, 5% bonus target, full benefits. www.careoregon.org / about-us / careers / benefits Posting Notes This is a Hybrid role that will require 1-2 days per week or month in the Community or our Downtown Portland office (or at least 9 times / year) Job Summary This position serves as a primary liaison between CareOregon Dental and the provider-partner network, which includes contracted, non-contracted, and potential providers. This position will act as a main resource for highly engaged, and often complex, contracted providers. This position is primarily responsible for provider lifecycle management, including an advanced level of provider onboarding, development, education, and relations. This position is a valuable liaison and collaborator with internal CareOregon teams and is essential in identifying network needs, gaps, and resolutions. This position assists with ensuring contract and regulatory requirements are met, site visits completed, data reports are reviewed, and the contract development process is supported. Work is focused on the CareOregon Dental network. Essential Responsibilities Provider Development & Education Develop and effectively communicate strong understanding of network eligibility and maintains effective working relationships across a high performing provider network. Develop and effectively communicate expert understanding of network eligibility and available resources to ensure a high performing and engaged provider network. Play a key role in new provider contract determinations and oversight of eligibility criteria. Conduct new provider orientations (PDPs, Specialists, Vendors) and identify training opportunities for clinic office staff such as, but not limited to CareOregon administrative processes and regulatory requirements. Autonomously develop and lead group training sessions and presentations. Provider Relations Cultivate relationships with providers to enhance the provider experience, access to quality of care for members, and healthcare transformation. Engage the CareOregon Dental provider network to develop, address, and monitor performance. Conduct provider site visits to maintain ongoing effective and professional relationships. Track, research, and resolve provider questions; ensure appropriate resources are offered and root cause of provider issues are appropriately documented and addressed. Perform provider complaint resolution with contracted and non-contracted entities, including PDPs, specialists and vendors. Address contractual issues and concerns; conduct complaint visits as needed. Act as a key liaison to clinics to understand and use standard reporting, including capacity, financial, member assignments, and utilization. Promote and advocate for provider engag
Salary : $71,340 - $87,200
