Provider Relations Supervisor

Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

In this role, you'll lead relationship building by cultivating and strengthening partnerships with a diverse range of providers to foster long-term, positive working relationships. The Provider Relations Supervisor will play a pivotal role in educating and training providers, provider relations staff, and collaborate with other internal departments on best practices, policies, and procedures to ensure they are fully equipped to deliver top-quality care to our members and providers. You will be the go-to resource for resolving provider issues, coordinating efforts to troubleshoot challenges, and facilitating continuous improvements. It will be necessary to work closely with internal departments to share insights, identify opportunities, and contribute to projects that enhance provider experience and operational success.

Functional Competencies:

• Assist the Provider Relations Manager with oversight in managing and leading the overall success of the Provider Relations Department, driving a positive Avesis provider experience and provider satisfaction.
• Conduct scheduled team meetings with assigned team members as well as schedule individual meetings with staff.
• Operate and function as the leader with a take charge attitude.
• Be able to hold difficult conversations as well as empower employees through positive conversations.
• Serve as a Subject Matter Expert (SME) and escalation point to coach Provider Relations/Services staff in providing the best service experience and timely issue resolution possible.
• Accountable leader for the Provider Relations/Services staff in their effectiveness, career development, and team morale
• Partner with cross-functional departments to develop and implement operational improvements to daily workflows.
• Accountable leader to the Provider Relations team success to include department operational, quality, and individual KPIs.
• Conducts provider outreach by providing training and guidance to enable Avesis network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools.
• Responds to general provider contract inquiries, provider education and non-routine claim issues and may research, analyze, and recommend resolution for provider disputes.
• Ability to review and negotiate fee exceptions and submit documentation through the proper channels.
• Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues.
• Working knowledge of credentialing process
• Perform onsite facility reviews, when applicable and conduct quarterly face-to-face visits within the assigned territories and/or markets. Work closely and coordinates with Avesis Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for various provider network projects.
• Investigate and respond to complex provider related issues and initiate change of provider related database information.
• Knowledge of and ability to use various computer programs such as Microsoft Office including spreadsheet, word processing and presentation software and programs/systems utilized in data analysis.
• Attend work-related events/conferences while representing the organization and brand in a professional manner.

Core Competencies:

• Intermediate PowerPoint skills required; ability to highlight details, provide visual structure using themes, importing Excel data, adding links, playing video files, using animation, and preparing for a live slideshow.
• Microsoft applications and other windows-based applications to include a moderate level in Microsoft Excel, Microsoft Word, Microsoft OneNote, and databases.

Behavioral Competencies:

• Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth.
• Initiative: readiness to lead or take action to achieve goals.
• Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing.
• Member-focused: going above and beyond to make our members feel seen, valued, and appreciated.
• Detail-oriented and thorough: managing and completing details of assignments without too much oversight.
• Flexible and responsive: managing new demands, changes, and situations.
• Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task.
• Integrity & responsibility: acting with a clear sense of ownership for actions, decisions and keeping information confidential when required.
• Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.

Minimum Qualifications:

• High School Diploma or equivalent.
• 3+ years government and/or commercial dental work experience required.
• 1+ years in a leadership capacity (management, projects, processes, etc).
• A valid driver's license with proof of auto insurance and the ability to use your own vehicle.
• The ability to travel up to 50% is required to meet prospective clients, existing customers, attend trade shows and other meetings as needed. Travel times may vary and can range from short overnight trips to extended stays.
• As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient.

Preferred Qualifications:

• Bachelor's degree
• Provider Relations experience preferred.
• Knowledge of health plan operations preferred.
• Dental Assisting National Board (DANB) certified or Certified Dental Assistance (CDA) preferred.

FLSA Status: Salary/Exempt

National Salary Range: $55,790 - 109,040

Bonus Eligible: Annual Incentive Plan (AIP)

How to stay safe:

Avesis is aware of fraudulent activity by individuals falsely representing themselves as Avesis recruiters. In some instances, these individuals may even contact applicants with a job offer letter, ask applicants to make purchases (i.e., a laptop or gift cards) from a designated vendor, have applicants fill out W-2 forms, or ask that applicants ship or send packages of goods to the company.

Avesis would never make such requests to applicants at any time throughout our job application process. We also would never ask applicants for personal information, such as passport numbers, bank account numbers, or social security numbers, during process. Our recruitment process takes place by phone and via trusted business communication platform (i.e., Zoom, Webex, Microsoft Teams, etc.). Any emails from Avesis recruiters will come from a verified email address ending in @Avesis.com.

We urge all applicants to exercise caution. If something feels off about your interactions, we encourage you to suspend or cease communications. If you are unsure of the legitimacy of a communication you have received, please reach out to ITsupport@Avesis.com.

To learn more about protecting yourself from fraudulent activity, please refer to this article link (https://consumer.ftc.gov/articles/how-avoid-scam). If you believe you were a victim of fraudulent activity, please contact your local authorities or file a complaint (Link: https://reportfraud.ftc.gov/#/) with the Federal Trade Commission. Avesis is not responsible for any claims, losses, damages, or expenses resulting from unaffiliated individuals of the company or their fraudulent activity.

We Offer

• Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
• Competitive compensation package.
• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
• Life and disability insurance.
• A great 401(k) with company match.
• Tuition assistance, paid parental leave and backup family care.
• Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
• Employee Resource Groups that advocate for inclusion and diversity in all that we do.
• Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.

Equal Employment Opportunity

At Avsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avsis, where We See You!