Partner Engagement Specialist

DeltaDentalNE; Minneapolis (MN); Hybrid; USD 29,000 - 36,000; Full time

Job summary

Delta Dental of Minnesota is seeking a Partner Engagement Specialist to support Medicaid and Medicare lines. You will manage a high volume of emails, perform project tasks, conduct escalated research, and help develop processes. This role requires coordinating with DHS, MCOs, and TPAs and ensuring policy adherence.

This position is with Stratacor, an affiliate of Delta Dental of Minnesota, and requires authorization to work in the U.S. No visa sponsorship available.

Qualifications

• Associate's degree or equivalent work experience required.
• 1+ years of experience in healthcare insurance preferred.
• Experience researching and resolving customer inquiries.

Responsibilities

• Partner and collaborate with Manager of Partner Relations and work independently to research and resolve escalated items within appropriate turnaround times and follow up to ensure solution.
• Identify, assess, and solution for process improvement and efficiency.
• Responsible for administering functional process documentation.
• Review and monitor Government Programs networks, and manage outreach projects in conjunction with DHS and/or MCO partners.
• Partner with MCOs, key stakeholders, and TPAs to ensure accurate and timely file transmissions, creation of reports, enhancements of reports, and research of incidents.
• Monitor Government Programs monthly performance standard reports and monitor to ensure service level agreements are being met; partner to design and implement corrective action plans as needed.
• Track and ensure benefit updates and changes for Medicaid and Medicare lines of business are carried out.
• Collaborate with internal functional leaders and TPA for client inquiries, escalated concerns, training management, and managing process change.

Skills

Communication

Multitasking

MS Office

Relationship-building

Project management

Analytical skills

Education

Associate's degree in business or related

Healthcare insurance experience

Tools

MS Office

Job description

Delta Dental of Minnesota is the largest regional provider of dental benefits, passionately serving over 7,000 Minnesota and North Dakota-based purchasing groups and 4.5 million members nationwide. We provide a work environment that engages each individual while encouraging growth and professional development. We are proud to be named a Top Workplace employer for several consecutive years and value our team members for building this reputation.

GENERAL SUMMARY

The Partner Engagement Specialist is responsible for providing day-to-day support of the Medicaid and Medicare lines of business. This role will be responsible for successfully managing and responding to a high volume of emails, project management tasks, escalated research, and process development initiatives. This role is responsible for administering established policies and procedures while acting as a liaison between the Company, county personnel, Managed Care Organizations (MCOs), Minnesota Department of Human Services (DHS), and third-party administrators (TPAs).

This position will be with Stratacor, an affiliate of Delta Dental of Minnesota.

Applications must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment authorization at this time.

ESSENTIAL FUNCTIONS

• Partner and collaborate with Manager of Partner Relations and work independently to research and resolve escalated items within appropriate turnaround times and follow up to ensure solution.
• Identify, assess, and solution for process improvement and efficiency.
• Responsible for administering functional process documentation.
• Review and monitor Government Programs networks, and manage outreach projects in conjunction with DHS and/or MCO partners.
• Partner with MCOs, key stakeholders, and TPAs to ensure accurate and timely file transmissions, creation of reports, enhancements of reports, and research of incidents.
• Monitor Government Programs monthly performance standard reports and monitor to ensure service level agreements are being met; partner to design and implement corrective action plans as needed.
• Track and ensure benefit updates and changes for Medicaid and Medicare lines of business are carried out.
• Collaborate with internal functional leaders and TPA for client inquiries, escalated concerns, training management, and managing process change.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the team member. Duties, responsibilities and activities may change or be assigned at any time with or without notice.

KNOWLEDGE, SKILLS AND ABILITIES

Required:

• Strong verbal, written, and presentation skills.
• Excellent interpersonal skills with the ability to build relationships with internal and external stakeholders.
• Ability to multi-task, self-motivate, and successfully operate in a fast-paced, team environment.
• Ability to manage time effectively and meet established deadlines.
• Must adapt well to change and successfully set and adjust priorities as needed with an appropriate sense of urgency.
• Capable of researching an issue and following through to its conclusion/resolution.
• Ability to demonstrate considerable tact, diplomacy, discretion, and judgement when interacting with others, while also having the ability to build and maintain effective interpersonal relationships.
• Ability to collaborate and partner with internal and external stakeholders at all levels.
• Must have a high level of organizational skills, self-discipline, and motivation.
• Ability to follow policies and procedures and help develop process improvement opportunities to improve efficiencies when using good judgment.
• Solution driven problem-solving skills and proven analytical skills.
• Ability to work with little oversight, applying education and professional experience to achieve outstanding results.
• Proficient with MS Office (E.g., Outlook, Word, Excel, PowerPoint).

Preferred:

• Ability and interest in analyzing and synthesizing data for internal and external stakeholders.

EDUCATION AND EXPERIENCE

Required:

• Associate's degree in business or related degree; and/or equivalent work experience
• 1+ years of experience working in healthcare insurance
• Experience researching and resolving customer inquiries

Preferred:

• Experience with Managed Care Organizations and/or government programs
• Dental insurance industry experience

WORK ENVIRONMENT/PHYSICAL DEMANDS

• Travel Requirements: Periodic local client visits
• Weight Lifting Requirements:20 lbs.
• Sedentary Work: Extended periods of sitting at a workstation while working on a computer.

RELATIONSHIPS

• Reports To: Manager, Partner Relations
• Directly Manages:None
• Internal Relationships: Interface with enterprise-wide staff at all levels
• External Relationships:Managed Care Organizations, Minnesota Department of Human Services, and Third-Party Vendors

The starting salary range for this position is between $21.00 and $26.00 per hour. Salary offers will typically be made in the listed range. The Company takes into consideration a candidate's education, training, and experience, as well as the position's work location, expected quality and quantity of work, required travel (if any), external market and internal value, including merit process and internal pay alignment when determining the salary for potential new team member's. In compliance with state and federal regulations, a potential new team member's salary history will not be used in compensation decisions.

EQUAL EMPLOYMENT OPPORTUNITY (EEO) STATEMENT

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.