Demo

Provider Partner Consultant, DentaQuest New York City

Sun Life Financial (U.S.) Services Company, Inc.
New York, NY Full Time
POSTED ON 1/15/2024 CLOSED ON 2/16/2024

What are the responsibilities and job description for the Provider Partner Consultant, DentaQuest New York City position at Sun Life Financial (U.S.) Services Company, Inc.?

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world. DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all. Job Description: ** Must be located in the 5 boroughs of NYC or mid-Hudson Valley ** 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. Job Summary: Responsible for developing and managing relationships with Providers within their assigned market. As such, spends most time communicating with providers about suite of benefit programs (Medicaid, Medicare Advantage, Marketplace and Direct to Consumer and Commercial and any blend of dental products) to support DLR in risk markets, and the P&L of the network. Works collaboratively with reporting to understand provider reports and promote continuous improvement to Providers (high performance metrics, cost, outliers, quality, etc.) Primary Responsibilities: Maintain visibility within their market, with an eye toward 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 to improve their understanding of all available benefit programs. Responsible for educating providers, serve as primary point of contact for instruction and advising of the comprehensive policies and procedures involving all phases of the corporation’s benefits and contracts through office visits and communication over the phone and email. Promote dentist adoption of technology solutions by promoting Web applications and increasing the volume of electronic claims. Seek continuous improvements by recommending changes in internal methods and procedures to Quality Assurance process. Facilitate Oral Health presentations to various educational institutions and organizations. Represent clients and company at trade shows, health fairs, audits, dental summits, etc. throughout the designated market and/or state. Responsible for creation, and submission of all required reports. Acts as a subject matter expert for their respective geographic area Develop complete understanding of the Office Reference Manuals for implementation within their region. Develop and continually improve personalized presentations of company benefit programs Provide recommended solutions to market related issues. Measure impact of provider satisfaction (as tied to annual objectives of the team) and respond to provider issues. Organize and present information to providers and their staff by speaking before various provider organizations and representing the corporation in dental related activities. Assist in problem resolution by identifying improvement opportunities, evaluating feasibility of programs and presenting recommendations when appropriate. Performs in depth analysis of fee schedules, including fee schedule comparisons, to negotiate competitive custom fee schedules where needed Provides 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 to ensure effective contract performance.  Support innovative business practices and process improvement opportunities for current and prospective clients (e.g., P4Q, QARR, ER Diversion). Maintain a secondary network to ensure access to care for all eligible members. Other duties as assigned. Qualifications: Bachelor's degree in business, Healthcare Administration or related field (or relevant work experience) 3 years’ related work experience in 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 Problem solving and training experience 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 Ability to efficiently operate all job-related office equipment. Ability to communicate via telephone and work in virtual teams The office environment is active with high voice levels and interruptions that may challenge hearing and concentration. 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. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! Life is brighter when you work at Sun Life Excellent benefits and wellness programs to support the three pillars of your well-being – mental, physical and financial – including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account A flexible work environment with a friendly, caring, collaborative and inclusive culture Great Place to Work® Certified in Canada and the U.S. Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running 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. The salary range for this position is $72,500-$108,900 annually. We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits. Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter -for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more. At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs. #LI-remote Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email recruitingUS@sunlife.com to request an accommodation. At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs. For applicants residing in California, please read our employee California Privacy Policy and Notice. Job Category: Sales - Client Relationship Management Posting End Date: 11/04/2024 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 Shine together At Sun Life, you can be your most brilliant self. Our supportive, flexible, and inclusive work environment is one where you – and your career – can thrive. Whatever your aspirations, collaborative leaders and colleagues are ready to help you learn, grow, and succeed. Make life brighter We’re a global company with a passion for people. Our purpose is to help Clients achieve lifetime financial security and live healthier lives. As a team of 30,000 across 26 countries, our impact is far-reaching, and locally relevant There’s power in numbers. As part of Sun Life’s growing team, you have an impact on people in your community and around the world. Shape the future With an optimistic eye on a brighter future, we drive to innovate. Be part of leading change, push boundaries and try new ways of working. Use data to drive bold actions. Be agile and pivot as we test and learn. At Sun Life, we’re driving transformation, sustainability and innovation for our Clients, employees, partners, and communities. Join us. Together, we can make the future brighter. Join a top employer for a brighter future. Visit Sun Life Careers
Technical Director Job at Church of the City New York in New York
Church of the City New York -
New York, NY
Video Technician Job at City of New York in New York
City of New York -
New York, NY
Digital Content Manager Job at City of New York in New York
City of New York -
New York, NY

If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

Sign up to receive alerts about other jobs with skills like those required for the Provider Partner Consultant, DentaQuest New York City.

Click the checkbox next to the jobs that you are interested in.

  • Batch Testing Skill

    • Income Estimation: $47,729 - $61,141
    • Income Estimation: $52,222 - $66,824
  • Business Process Modeling/Improvement Skill

    • Income Estimation: $96,480 - $119,037
    • Income Estimation: $98,792 - $130,224
This job has expired.
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

Not the job you're looking for? Here are some other Provider Partner Consultant, DentaQuest New York City jobs in the New York, NY area that may be a better fit.

Deckhand - City Cruises - New York

City Cruises New York, New York, NY

AI Assistant is available now!

Feel free to start your new journey!