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About the Role

The Provider Partner Consultant develops and manages relationships with providers within their assigned market, communicating benefit programs to aid in risk markets and network P&L. This role collaborates to discern provider reports and promote continuous improvement in performance metrics, cost, quality, and outliers.

Responsibilities

• Maintain market visibility and manage the network across all product lines.
• Evaluate and monitor provider cost reports to improve providers’ cost and quality performance.
• Recruit new providers and maintain network participation by educating dentists and dental office managers on benefit programs.
• Educate providers and serve as the primary point of contact for policies and procedures involving benefits and contracts.
• Promote dentist adoption of technology solutions and increase electronic claims volume.
• Recommend changes in internal methods and procedures to the Quality Assurance process for continuous improvement.
• Facilitate Oral Health presentations to educational institutions and organizations.
• Represent clients and company at trade shows, health fairs, audits, and dental summits.
• Govern the creation and submission of all required reports.
• Act as a subject matter expert for the respective geographic area.
• Develop a complete grasp of Office Reference Manuals for implementation within the region.
• Develop and continually improve personalized presentations of company benefit programs.
• Provide recommended solutions to market-related issues.
• Measure 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 evaluating program feasibility.
• Investigate fee schedules to negotiate competitive custom fee schedules.
• Provide regular updates to senior management on network market performance.
• Develop and implement processes to improve client and provider satisfaction.
• Develop and maintain relationships with appropriate functional areas for effective contract performance.
• Aid innovative business practices and process improvement opportunities.
• Maintain a secondary network to ensure access to care for all eligible members.
• Perform other duties as assigned.

Requirements

• Must reside in NY or in the Northeast region of the United States.
• Ability to travel up to 50% locally.

Skills

• Dental knowledge
• Managed Care experience
• Strong presentation skills
• Excellent verbal and written communication skills
• Ability to work independently and as part of a team
• Knowledge of Microsoft Office

Location

• NY
• Northeast region of the United States

Work Type

• Full-time

Experience Level

• Five (5) or more years of office experience

Salary/Compensations

• $63,000 - $94,500

Benefits

• Discretionary annual incentive award
• Generous vacation and sick time
• Market-leading paid family, parental and adoption leave
• Medical coverage
• Company paid life and AD&D insurance
• Disability programs
• Partially paid sabbatical program
• 401(k) employer match
• Stock purchase options
• Employer-funded retirement account

About the Company

• Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need.
• Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
• We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.
• At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives.
• Our values shape how we work: caring, authentic, bold, inspiring, and impactful.
• 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.

Equal Opportunity

• 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.