Provider Engagement Specialist - Dental Network ...

Join our dedicated team and make health a primary focus! The Provider Engagement Specialist is essential in building and nurturing long-lasting relationships with healthcare providers, including physicians and healthcare systems. Your efforts will directly contribute to enhancing financial and quality outcomes through effective collaboration with our health plan. In this role, you will actively engage with the Provider Network, promoting the advantages of joining the Humana Dental Network while developing strong professional relationships. You will create a seamless environment for providers, ensuring easy navigation and communication. Collaborate with dental service organizations (DSO) and large group partners on credentialing and re-credentialing initiatives. Work closely with the claims unit to identify and swiftly resolve claims issues for providers across various systems. Educate Provider Offices on both current and new products and plans. Offer comprehensive support to Provider Offices with all maintenance and service inquiries. Assist in member/provider disputes, providing the necessary support to the Special Investigations Unit (SIU) and Grievances & Appeals (G&A). Help Provider Offices and Rental Partners with contract-related queries and challenges. Engage proactively with providers regarding fee schedules and financial incentive discussions. Collaborate with Rental Partners to ensure the effective implementation of cost-saving initiatives. Add or terminate locations, associates, and products within existing provider relationships as needed. Support new product rollouts and participate in re-contracting efforts. Process provider terminations as necessary. Make a significant impact with your skills! Required Qualifications: Minimum of 2 years of experience with Dental platforms. Strong attention to detail is essential. Proactive problem-solving and root cause analysis skills. Exceptional verbal and written communication abilities. Ability to multitask and manage numerous projects to meet deadlines. Willingness to learn and advance your professional career. Proficient in Excel and Outlook. Prior experience in customer care/service settings is preferable. Strong organizational skills are a must. Preferred Qualifications: Bachelor's Degree. 3-4 years of experience in the healthcare industry. Experience with MTV, CBIS, QicLink, and DPNMS. Familiarity with dental codes is an advantage. Additional Information: For remote positions, a minimum download speed of 25 Mbps and upload speed of 10 Mbps is recommended; wired cable or DSL connections are preferred. Satellite, cellular, and microwave internet may be used only if approved by leadership. Associates working from home in California, Illinois, Montana, or South Dakota will receive bi-weekly internet expense payments. Humana provides appropriate telephone equipment for home or hybrid associates to meet business requirements. Ensure a dedicated workspace free from ongoing distractions to protect member PHI and HIPAA information. Travel: This is a remote position, but occasional travel to Humana offices for training or meetings may be required. Scheduled Weekly Hours: 40 Pay Range: The salary range reflects a good faith estimate of starting base pay for full-time (40 hours a week) employment at the time of posting. The pay range may be higher or lower based on geographic location, and individual compensation will vary according to demonstrated job-related skills, knowledge, experience, education, and certifications. $48,900 - $66,200 per year Description of Benefits: Humana, Inc. and its subsidiaries offer competitive benefits that reflect a commitment to overall well-being. Our benefits support personal health and informed healthcare decisions for you and your family. We provide medical, dental, and vision coverage, a 401(k) retirement savings plan, generous time off, and various other developmental opportunities. Application Deadline: 02-27-2026 About Us: Humana Inc. is dedicated to prioritizing health for our teammates, customers, and communities. We aim to simplify healthcare and improve the quality of life for individuals across Medicare, Medicaid, and beyond. Equal Opportunity Employer: Humana is an equal opportunity employer and does not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. We actively comply with affirmative action policies and support individuals with disabilities and protected veterans in our hiring processes. Humana adheres to all applicable federal civil rights laws and prohibits discrimination based on race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. We also provide free language interpreter services.

Created: 2026-03-16