Provider Partner Consultant

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🔥 0 minutes ago

🌪️ Oklahoma – Remote

🌪️ Oklahoma – Remote

💵 $60.5k - $90.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

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Sun Life

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1865

💼 Consulting

🏥 Healthcare

💸 Finance

Consulting • Healthcare • Finance

Sun Life is a global financial services company headquartered in Toronto, Canada, offering a diverse range of protection, wealth, and health solutions for individuals, businesses, and institutions. The company provides services in insurance, investments, financial advice, and asset management across various regions including North America, Asia, and Europe. Sun Life is committed to sustainability, diversity and inclusion, and creating a positive impact in communities. With a focus on achieving financial security and healthier lives for their clients, Sun Life integrates comprehensive financial solutions and innovative practices to meet the evolving needs of their clientele.

📋 Description

• Analyze and monitor provider cost reports to educate providers and improve cost and quality performance • Support dentists and dental office managers in understanding benefit programs, policies and procedures • Educate providers through office visits, phone and email communication • Promote technology solutions, web applications and electronic claims • Negotiate special deals to maintain compliance and increase access in weak networks • Recommend improvements to internal methods, procedures and Quality Assurance processes • Facilitate oral health presentations for educational institutions and organizations • Assist provider offices with electronic claims filing • Answer remittance, payment, benefit, claims and eligibility questions • Follow up on provider termination letters • Represent clients and the company at trade shows, health fairs, audits and dental summits • Maintain and submit required reports • Resolve elevated complaints and issues for clients, members and providers • Recruit providers and increase participation across applicable market lines of business • Manage CAP office performance and recommend solutions to market issues • Organize and present information to providers and staff • Identify improvement opportunities, evaluate program feasibility and present recommendations • Improve information exchange between the company and dental offices • Resolve difficult claims issues with internal resources • Strengthen and expand provider networks and maintain a secondary network

🎯 Requirements

• Bachelor’s Degree in Business, Healthcare Administration or related field, or relevant work experience • 3 years’ related work experience in a 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 required • Problem-solving and training experience • Ability to make sound judgments based on available data with minimal supervision • Dental knowledge with five or more years of office experience preferred • Managed Care experience preferred

🏖️ Benefits

• Discretionary annual incentive award based on individual and business performance • Generous vacation and sick time • 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 • Flexible, inclusive and collaborative work environment • Career growth support • Reasonable accommodations for qualified individuals with disabilities or special disabled veterans