Dental Network LiaisonPrimary Location: Albany, NY
Additional Locations: NY-Albany Apply
69471Fundamental Components: Act as the liaison with the Primary Care Dentists and Specialists in a specific geographic territory responsible for overall maintenance and territory management of the provider network, as a functional subject matter expert, demonstrating a strong understanding of Aetna's Dental Products and market position. Negotiation of contract language and provider compensation Review quality and service reports with provider and appropriate staff, contacting Dental providers regarding quality reviews conducted where unacceptable results were obtained Timely response to correspondence from Provider offices, included, but not limited to termination requests, tax id changes, hold requests, claim reimbursement, system, directory accuracy and various contractual issues. Documented resolution and follow through communicated to all parties Presentation of DHMO and PPO plan design, compensation process, claim / encounter submission, and referral policies during new office orientations and reorientations via the telephone Knowledge of the competitive market and Aetna's relevant competitive position, to include member appointment access Presentation of Aetna's electronic capabilities for dental providers to achieve companies goals and targets, promote all EDI initiatives Special Ad Hoc Project as assigned Background Experience: Some Dental office experience is helpful, 3 years experience in managed care environment dealing with either dental or medical providers. Preferred BA Degree, High School diploma mandatory. Additional Job Information: Customer focused. Knowledge of dental DMO and PPO products preferred. Strong verbal and written communication skills. Negotiation skills. Required Skills: General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, General Business - Turning Data into Information Desired Skills: General Business - Applying Reasoned Judgment, General Business - Managing Sales Relationships, General Business - Maximizing Work Practices Functional Skills: Network Management - Contract negotiation, Network Management - Credentialing, Network Management - Physician recruiting - dental, Network Management - Provider relations, Products-Dental - DMO Potential Telework Position: Yes Percent of Travel Required: 25 - 50% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Candidate Privacy Information: Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
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