National Dental Contracting Professional - Medicaid - VSP

📋 Description

• • As a National Dental Contracting Professional for Humana's Medicaid program, you will play a pivotal role in expanding access to essential dental care for vulnerable populations. Your primary mission will be to identify, engage, and successfully contract with qualified dentists and dental practices across the nation to join our Medicaid dental network. This critical function ensures that our network not only meets but exceeds the stringent accessibility, quality, and compliance standards mandated by Medicaid regulations and Humana's own high-quality policies. By building robust relationships with dental providers and meticulously managing the contracting and onboarding processes, you will directly contribute to enhancing the overall dental health and well-being of the millions of members we serve.
• • Your day-to-day responsibilities will be dynamic and multifaceted, centered around strategic provider recruitment and network development. You will proactively source and identify potential dentists and dental practices that align with our network's needs, employing a variety of outreach strategies. This includes conducting targeted cold calling campaigns, leveraging professional networking opportunities, and actively participating in relevant industry events to build a strong pipeline of prospective providers. A significant part of your role will involve presenting the compelling benefits of joining Humana's Medicaid dental network, effectively articulating our value proposition and adeptly addressing any questions or concerns dental professionals may have. You will be instrumental in facilitating the entire contracting process, which involves negotiating favorable terms, meticulously collecting all necessary documentation, and ensuring strict adherence to both state and federal Medicaid guidelines. Furthermore, you will collaborate closely with various internal Humana teams, including legal, credentialing, and provider relations, to ensure a seamless and supportive onboarding experience for every new provider joining our network. Maintaining precise and up-to-date records of all recruitment activities, contract statuses, and provider information is paramount, ensuring compliance with both company policies and regulatory requirements. You will also be tasked with monitoring evolving market trends and actively soliciting provider feedback to continuously optimize our recruitment strategies and ensure robust network adequacy across all service areas. A key aspect of this role involves participating in ongoing training to stay abreast of the latest Medicaid dental program requirements and best practices in provider network management. Additionally, you will be responsible for developing, coordinating, and delivering educational programs designed to inform dental providers about Medicaid policies, compliance mandates, best practices, and program updates, ultimately fostering improved quality of care and enhanced adherence to regulatory standards.
• • You will be joining a dedicated team within Humana, a leading U.S. healthcare company committed to improving the lives of millions. Humana is recognized for its comprehensive approach to healthcare, offering both insurance services and innovative healthcare delivery through its CenterWell services. This role offers the unique opportunity to contribute to a mission-driven organization that is making a tangible difference in the lives of people with Medicare and Medicaid, families, individuals, and military service personnel. You will be part of a culture that values collaboration, innovation, and a deep commitment to member well-being.
• • In this role, you will have the opportunity to significantly deepen your expertise in Medicaid dental programs, provider contracting intricacies, and the nuances of fee negotiations and regulatory compliance within the healthcare industry. You will hone your skills in strategic outreach, relationship management, and project coordination, becoming a subject matter expert in network development. The success you achieve in this position will directly impact the accessibility of dental care for underserved communities, offering a profound sense of accomplishment and the chance to make a lasting positive impact on public health. You will also gain valuable experience working within a large, established healthcare organization, understanding its operational dynamics and contributing to its overarching mission of fostering whole-person well-being.