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National Dental Contracting Professional - Medicaid

100% Remote Full-time Open now

About the position The National Dental Contracting Professional is responsible for identifying, engaging, and contracting with qualified dentists to join the insurance carrier's Medicaid dental network. This role ensures the network meets accessibility, quality, and compliance standards as required by Medicaid regulations and company policies. You will develop relationships with dental providers, manages the contracting process, and supports provider onboarding to enhance member access to dental care. Proactively source and identify dentists and dental practices for participation in the Medicaid dental network. Develop and implement outreach strategies to attract qualified dental providers, including cold calling, networking, and attending industry events. Present the benefits of participating in the insurance carrier's Medicaid network and address questions or concerns from providers. Facilitate the contracting process, including negotiating terms, collecting required documentation, and ensuring compliance with state and federal Medicaid guidelines. Collaborate with internal teams (legal, credentialing, provider relations) to support a smooth onboarding experience for new providers. Maintain accurate records of recruitment activities, contract status, and provider information in accordance with company and regulatory standards. Monitor market trends and provider feedback to optimize recruitment efforts and network adequacy. Participate in ongoing training related to Medicaid dental program requirements and provider network management. Responsible for developing, coordinating, and delivering educational programs to dental providers participating in Medicaid. Ensures providers understand Medicaid policies, compliance requirements, best practices, and program updates, thereby improving quality of care and adherence to regulatory standards.

Responsibilities

  • Proactively source and identify dentists and dental practices for participation in the Medicaid dental network.
  • Develop and implement outreach strategies to attract qualified dental providers, including cold calling, networking, and attending industry events.
  • Present the benefits of participating in the insurance carrier's Medicaid network and address questions or concerns from providers.
  • Facilitate the contracting process, including negotiating terms, collecting required documentation, and ensuring compliance with state and federal Medicaid guidelines.
  • Collaborate with internal teams (legal, credentialing, provider relations) to support a smooth onboarding experience for new providers.
  • Maintain accurate records of recruitment activities, contract status, and provider information in accordance with company and regulatory standards.
  • Monitor market trends and provider feedback to optimize recruitment efforts and network adequacy.
  • Participate in ongoing training related to Medicaid dental program requirements and provider network management.
  • Responsible for developing, coordinating, and delivering educational programs to dental providers participating in Medicaid.
  • Ensures providers understand Medicaid policies, compliance requirements, best practices, and program updates, thereby improving quality of care and adherence to regulatory standards.

Requirements

  • Minimum of 4 years of experience in dental provider Medicaid recruitment, provider service and retention.
  • Knowledge of Medicaid dental programs, provider contracting, fee negotiations, and regulatory compliance is highly desirable.
  • Excellent communication, public speaking and relationship-building skills.
  • Strong organizational and project management abilities.
  • Proficiency with Microsoft Office and salesforce platform.
  • Travel as needed for business needs.
  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
  • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice-to-haves

  • Bachelor's degree in business, healthcare administration, or related field preferred.

Benefits

  • medical
  • dental
  • vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance

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