Dental Network Contract Coordinator

HealthPartners is currently hiring for a Dental Network Contract Coordinator.

POSITION PURPOSE:

1. To serve as the dental division's primary business reporting representative for all initiatives and interfaces that pertain to the Consolidated Provider Network (CPN) data systems, including HealthPartners Customer Service System (HCSS), HealthPartners.com, directory application.

2. To participate in making the dental division's provider and network data available for organizational needs through the creation and running of ad hoc and standard reports.

3. To develop, document and carry out business user test plans and scenarios related to modifications of dental network support systems.

4. To develop, document and carry out audit processes for dental provider and network data.

5. To serve as an administrative and operational contact for both primary and specialty contracted and PPO dental providers in regards to HPI products, policies, procedures, and systems. This network consists of over 2,300 dental providers serving HealthPartners dental members.

6. To develop, maintain and improve quality relationships with dental contracted groups through frequent and varied communications. This position is responsible for problem resolution and process improvement with contracted dental providers.

7. Assist in the implementation of a new contracted dental office including provider relations activities coordination of internal communication of information to various areas for new clinic set-up.

ACCOUNTABILITIES:

1. Provide dental business knowledge to multi-departmental work groups involved in provider systems development and modifications. This includes initiatives dedicated to interface development for business systems requiring dental provider data.

2. Maintain provider and network data using the CPN, and CACTUS applications.

3. Maintain network data including products, delivery networks, referral associations, and plan set up for the HealthPartners website using the CPN applications.

4. Develop and implement user test plans and scenarios for CPN, HCSS, and HP.com modifications.

5. Analyze, maintain and provide information regarding confidential contracted provider fee schedules and fee arrangements.

6. Support communications with external HealthPartners customers and/or partners on issues related to providers and clinic data.

7. Review and approve confidential provider data from Dental Change reports generated by Dental Credentialing through CACTUS.

8. Liaison to Member Services on all provider, dental products, network issues and questions or issues related to provider and clinic data.

9. Complete special dental network management related projects including updating provider manuals, coordinating the implementation of electronic connectivity programs and provider reports.

10. Assist in the coordination of processes related to the termination of a dental clinic/group. This includes developing a work plan for large clinic groups, communications and coordination of member communications.

11. Provide support and assist with provider recruitment activities.

12. Perform other related duties at the request of the Manager of Dental Contracting.

REQUIRED QUALIFICATIONS: (Minimum qualifications needed for this position)

• Associate degree or equivalent experience in a provider relations or similar position requiring direct responsibilities related to the administration of provider networks.

• Two to three years of experience in a provider relations, customer service, health care management, or related position.

• Provider perspective as evidenced by two years experience in a health care setting.

• Two years of experience in PC based systems and applications including: strong Word and Excel skills such as mail merges, newsletter or manual production; creation and manipulation of Excel spreadsheets.

• Experience in auditing and analyzing data

• Strong verbal and interpersonal communication skills

• Ability to identify and resolve problems independently

• Demonstrated excellent aptitude for details, organization and self-motivation.

• Ability to prioritize and work on multiple projects simultaneously while under deadline

• Ability to make well-thought decisions within his/her range of responsibilities.

• Knowledge of relational database structure.

• Demonstrated aptitude for details and self-audit.

• Ability to make well-thought decisions within his/her range of responsibilities with very strong organization skills and the ability to work independently.

PREFERRED QUALIFICATIONS:

• Bachelor's degree in a related field

• Three years of provider relations experience in a managed care setting (HMO, DMO).

• One year experience with data query tools such as Microsoft Access or Business Objects.

• One year experience with HealthPartners provider systems (CPN, CCS, or HCSS).

• Knowledge of dental terminology.

• Knowledge of Business Objects and/or Access Reporting databases

• Knowledge of relational databases.

• One year experience working with a relational provider database.

• Experience in data auditing

DECISION MAKING:

The Dental Network Coordinator will operate with a high degree of independence in the

execution of agreed upon responsibilities. He/she must represent and make decisions surrounding the

business needs of the dental division in regards to design needs and modification of provider systems.

Included in this area is the analysis and approval of specification for system design modifications. The

Coordinator will also make decisions on the most effective and appropriate strategies for dental

provider data collection, auditing and reporting, in order to meet the needs of both internal and external

customers. He/she will be the provider relations contact for contracted dental groups and must have the

ability to make decisions and resolve issues that is in the best interest of the provider/clinic as well as

balancing with the objectives of HPI, when the manager isn't available.