Los Angeles, CA Provider Partner Consultant, DentaQuest

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. Through employers, industry partners and government programs, 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.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

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.

The opportunity:

At Sun Life, we look for optimistic people who want to make life brighter for ourClients.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 challengedbyworking independently and as a team withdynamic colleaguesto find new and innovative ways to make Sun Life the best benefits company in America.

** Candidates must reside in the Los Angeles, CA area.

How you will contribute:

• Maintain visibility within their market, with an eye toward managing their network across all product lines.

• 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.

• Collect necessary contract and credentialing documents from providers and follow up on outstanding paperwork.

• Conduct on-site structural reviews and orientation according to established guidelines.

• Develop complete understanding of the Office Reference Manuals for implementation within their region.

• Analyze existing provider network and determine if additional recruitment of providers is necessary to meet access standards.

• Performs in depth analysis of fee schedules, including fee schedule comparisons, to negotiate competitive custom fee schedules where needed

• 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.

• Process and submit facility updates/ changes promptly to update internal systems.

• Establish and maintain strong relationships with providers to assure stable networks.

• Complete monthly activity reports and provide updates on various recruitment projects.

• Assist in problem resolution by identifying improvement opportunities, evaluating feasibility of programs and presenting recommendations when appropriate.

• Counsel providers on utilization and/or questionable billing patterns to ensure compliance.

• Provides regular updates to senior management on internal and external issues affecting network market performance.

• Provide recommended solutions to market related issues.

• Develop and maintain relationships with appropriate functional areas within DentaQuest to ensure effective contract performance.

• Other duties as assigned

What you will bring with you:

• Bachelor's degree in business, Healthcare Administration or related field (or relevant work experience).

• 5 years' prior network management experience, dental office management, managed healthcare, and/or related sales, including prior experience working with Dental DHMO network and/ or Dental PPO network.

• Candidates for this position must currently reside in Los Angeles County and/ or surrounding area and be able to travel regularly within the assigned territory.

• Problem solving and training experience.

• Ability to make good judgment conclusions based on data available with minimal supervision.

• Knowledge of dental terminology.

• Strong presentation and public speaking abilities.

• Strong verbal and written communication skills in English language; bilingual is a plus.

• Proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook, and SharePoint).

• Ability to negotiate fee schedules with providers.

• Must be detail oriented, strong customer service skills, strong organizational and time management skills.

• Ability to identify problems, research issues and follow through until issue is resolved.

• Managed Care, Medicaid or Medicare experience preferred.

Salary:

Salary Range: $63,000 - $94,500

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations 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 thebrightside@sunlife.comto request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

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.