Professional Relations Representative - HAWAII DENTAL SERVICE : Job Details

POSITION SUMMARY

The Professional Relations Representative (PR Rep) is responsible for establishing, servicing and growing relationships with the network providers (Commercial, Medicare and Medicaid), their staff and the dental community. Questions, concerns, and issues that arise from dental providers or their staff are addressed and resolved in a timely manner. The PR Rep performs the day-to-day operations as they relate to provider data, credentialing, recruitment, communications and outreach. The PR Rep coordinates and assists with seminars, workshops and similar HDS functions or events that are centered around network providers and/or their office staff.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Key Responsibilities

* Establishes, maintains and grows effective relationships with dentists and their staff who participate in the HDS networks, including Medicare and Medicaid. Build rapport and connections with regular contacts via phone calls, emails and on-site visits.

* Knowledgeable and familiar with the geo access and provider network make-up of their assigned territories to provide regular updates and suggest ways to improve access to care.

* Provides on-site training for dentists and their staff, including but not limited to the HDS online provider portal, basic dental insurance terminology, introduction to the Procedure Code Guidelines and assistance with the HDS networks.

* Addresses and resolves questions, concerns and issues in a timely manner that may arise from external customers, such as dentists and their staff including Delta Dental member companies or providers as well as internal customers such as other HDS departments.

* Meets or exceeds departmental goals, including but not limited to key performance indicators for site visits and productivity.

* Reviews for completeness network provider forms, including Medicare and Medicaid, related to provider file maintenance and credentialing. Enters the forms into the system accurately and processes them to conclusion.

* Included in the PR team's rotation to review, address and resolve emails, faxes and phone calls received in the PR email box and PR phone queue in a timely and accurate manner.

* Contacts providers or their office staff for ad hoc call outs to obtain certain data or information.

* Supports HDS participation in community health fairs and other such events by recruiting and working with providers, for example during oral health screenings or Q & As.

* Participates in and attends provider-related events, which may involve travel and/or occur after hours.

* Other miscellaneous duties and responsibilities as assigned by the Director of Professional Relations or Professional Relations Manager.

MINIMUM QUALIFICATIONS AND EXPERIENCE

Education

Bachelor's degree in Business Administration or Public Health Administration or equivalent is preferred.

Experience

At least three (3) years of outside sales experience, or progressively responsible health administration experience, preferably in the areas of dentist office administration, dental or health insurance or other health administration field.

Medicaid or Medicare experience is preferred.

Skills and Knowledge

* Ability to organize, analyze and problem-solve a range of issues, including complex situations.

* Ability to handle multiple tasks and prioritize with some distractions and attention to detail.

* Ability to communicate both orally and in writing with all levels of staff, customers, dentists, dentist office staff, and vendors on sensitive matters.

* Technical knowledge to understand computer applications for problem-solving (prefer Microsoft applications, such as OneDrive, Teams, Word, Excel, PowerPoint).

* Valid Hawaii driver's license and personal transportation vehicle required.

Note: The above information in this description has been designed to indicate the general nature and level of work performed by an employee in this classification. It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job. Hawaii Dental Service has the right to add to, revise, or delete information in this description. Reasonable accommodation will be made to enable qualified individuals with disabilities to perform the essential functions of this position.