Job Details

Job Summary

Homeland has partnered with a leading provider of employee benefits, specializing in dental health coverage for millions across the U.S. Our client is seeking a Provider Performance Improvement Field Specialist to join their team.

Our client is an ancillary insurance company dedicated to promoting wellness in members and communities through innovative, tailored solutions delivered with a personal touch. They envision a world where individuals live more fulfilling lives, communities thrive, and brighter futures await everyone. Success means consistently performing at a high level while embodying humility, helpfulness, and positivity. Their high expectations may not suit everyone, but for those who genuinely care about improving the human experience, this is a place where you can truly flourish.

The Provider Performance Improvement Field Specialist is pivotal in advancing quality improvement initiatives and enhancing the performance of dental providers within network. This role involves both remote and in-person collaboration with network providers and their teams. The specialist will analyze data, work closely with providers, and implement strategies aimed at improving patient care, provider satisfaction, and overall network performance. Key responsibilities include identifying areas for improvement, developing targeted interventions, and monitoring progress to ensure compliance with clinical best practices and regulatory standards.

Responsibilities

• Analyze provider performance data to identify trends, gaps, and improvement opportunities in clinical care, patient outcomes, and operational efficiency
• Develop and maintain performance reports, dashboards, and scorecards for dental providers, highlighting key metrics such as patient satisfaction, treatment outcomes, and service utilization
• Monitor provider compliance with clinical guidelines, regulatory requirements, and the company's quality standards
• Collaborate closely with dental providers to promote best practices, evidence-based treatment protocols, and quality improvement initiatives
• Conduct in-person and virtual training sessions, workshops, and webinars to educate providers on performance improvement strategies, clinical guidelines, and the company's requirements
• Provide individualized coaching and support to underperforming providers to help improve their practice performance
• Develop and implement targeted performance improvement programs to enhance provider quality, efficiency, and patient experience
• Collaborate with internal teams (e.g., clinical operations, quality management, provider relations) to design and execute initiatives)
• Ensure performance improvement efforts align with the company's goals, accreditation standards, and regulatory compliance
• Foster positive relationships with dental providers to ensure ongoing collaboration and engagement in performance improvement efforts
• Act as a liaison between providers and the company, addressing concerns, facilitating open communication, and providing feedback on performance metrics
• Assist in resolving provider grievances or disputes related to quality performance
• Utilize data analytics and performance metrics to assess the effectiveness of interventions and quality improvement initiatives
• Provide recommendations for continuous improvement based on data analysis, research, and benchmarking against industry standards
• Identify high-performing providers and promote best practices across the network using data insights
• Ensure dental providers comply with state and federal regulations, accreditation requirements, and health plan standards
• Monitor adherence to clinical guidelines and documentation practices, addressing any deficiencies or non-compliance issues
• Assist in preparing providers for audits, accreditation reviews, and quality assessments
• Collaborate with dental providers to enhance member engagement and satisfaction, ensuring care is member-centered, accessible, and high quality
• Analyze member satisfaction surveys and feedback to identify opportunities for providers to improve the member experience
• Implement strategies to enhance communication between providers and members, promoting preventive care and member education

Requirements

• Associate's degree or equivalent education and work experience in a similar role
• 2+ years of experience in healthcare quality improvement, provider relations, or a related field
• 2+ years of experience in managed care government programs, such as Medicaid and Medicare
• Ability to travel within Florida 75% of working hours (see travel information below)
• Capacity to accelerate impact and effectively collaborate across multiple teams to achieve common goals
• Strong written and verbal communication skills, with attention to detail and ability to produce concise, objective, and relevant documentation
• Valid driver's license and access to a personal vehicle Ability to travel up to 75% to meet with providers, including short/overnight trips and extended stays as needed Use of various transportation modes may include public transit (rail, bus) and air travel Travel/mileage reimbursement provided according to the IRS annual mileage program and company expense report policy
• Familiarity with dental clinical guidelines, best practices, and regulatory requirements, preferred
• Strong analytical skills with experience in data analysis and performance metrics, preferred
• Excellent communication, presentation, and interpersonal skills, with the ability to engage and influence dental providers, preferred
• Knowledge of quality improvement methodologies such as Lean, Six Sigma, or PDSA (Plan-Do-Study-Act) is a plus, preferred
• Proficiency in healthcare management software, data analytics tools, and Microsoft Office Suite, preferred

Benefits

Our client provides meaningful and challenging work that fosters innovation in a secure and compliant environment, alongside a competitive compensation package. Benefits include comprehensive medical, dental, vision, life, and disability coverage for employees and their dependents with no waiting period, a 401(k) plan with company match, tuition assistance, paid parental leave, and backup family care. Their collaborative workspaces encourage creativity and talent development, while flexible time off, dress code, and work location policies promote work-life balance. The company values inclusion and diversity through Employee Resource Groups and is dedicated to social responsibility, community outreach, educational partnerships, and sustainability efforts.

Summary

Apply today!

EEO Notice

Homeland LLC is an Equal Opportunity Employer. Homeland LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state, and local laws. Homeland LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.