Ct Provider Relations Representative
Doral Dental USA, LLC (Hartford, Connecticut)

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Join a Growing Company With An Important Mission!

Due to continued success and growth, Doral is looking to expand its team with talented processionals seeking challenging and rewarding opportunities. Doral is one of the largest dental administrators in the country, serving more than 10million Members. The company has locations in Mequon and Grafton, WI and is a division of Boston-based DentaQuest Ventures, one of the leading administrators of dental benefits in the country.

Doral is adding a CT Provider Relations Representative role to the Client Services team. This individual will be responsible for network anaylsis, network development, provider recruitment, service and retention. Specific responsibilities include:

·         Increase member access to quality dental care by strengthening and expanding the existing provider network.

·         Support the Connecticut Department of Social Services fiscal intermediary (EDS) in their enrollment of dental providers; facilitate provider enrollment.

·         Recruit participating and non-participating providers to higher levels of participation.

·         Analyze network adequacy utilizing GEO software and other data sources; work with network development team to develop and maintain network capacity and achieve designated provider to member ratios.

·         Serve as direct contact and resource for market providers.

·         Contact participating offices to proactively resolve issues and strengthen relationships.

·         Serve as a liaison between dental offices, EDS and Doral to facilitate resolution to provider questions or issues such as enrollment, billing, prior authorization and policy clarification.

·         Plan and conduct orientation and informational provider training seminars and individual provider office training sessions.

·         Represent Doral and the State of Connecticut’s Dental Initiative program at health fairs, audits, dental summits, etc.

·         Develop and continually improve personalized presentations of Doral and the Dental Initiative program via telephone and in person.

·         Assist with drafting provider newsletter articles.

·         Develop complete understanding of the provider Office Reference Manual.

·         Maintain and submit all required reports.

·         Assist in resolving complaints and issues for the State, members and providers.

·         Obtain testimonials/letters of recommendation from providers.

·         Update Connecticut Project Manager regularly on major issues, both internal and external.

·         Perform miscellaneous tasks including, but not limited to, assisting with projects as assigned by the Connecticut Project Manager.

Requirements for this role include experience in sales, marketing, healthcare, dental care or insurance industry, knowledge of government programs preferred, and knowledge of general computer software. (Excel, MS Word, PowerPoint and Access a plus). The ability to create and deliver presentations to various sized and structured groups, excellent verbal and written communication skills, and the ability to prioritize and aadapt to changing priorities. A Bachelor's degree is also preferred.