Manager, Provider Engagement, DentaQuest
Manager, Provider Engagement, DentaQuest
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$ 63000 - 94500
1 Vacancy
Job Description
Sun Life U.S. is one of the largest providers of employee and government benefits helping approximately 50 million Americans access the care and coverage they need. Through employers industry partners and government programs Sun Life U.S. offers a portfolio of benefits and services including dental vision disability absence management life supplemental health medical stop-loss insurance and healthcare navigation. We have more than 6400 employees and associates in our partner dental practices and operate nationwide.
DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based cost-effective solutions are designed for Medicaid and CHIP Medicare Advantage small and large businesses and individuals. With a focus on prevention and value we aim to make quality care accessible to improve the oral health of all.
Job Description:
Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK.
** Individuals must be located in the Western region of the United States.
The opportunity:
The Provider Engagement Manager is the primary point person for providers to improve their understanding of our benefit programs policies and procedures. This position is responsible for provider networks regarding office education technology promotion network recruitment (expansion and strengthening utilization) and general on boarding of newly contracted addition this role administers on-site office reviews as required by network rules and regulations.
How you will contribute:
Maintain network participation by providing support to dentists and dental office managers to improve their understanding of all available benefit programs.
Educate providers by instructing and advising of the comprehensive policies and procedures involving all phases of the corporations benefits and contracts through office visits and communication over the phone and email.
Promote dentist adoption of technology solutions by promoting Web applications and increasing the volume of electronic claims.
Recruit non-participating providers within cost and access goals.
Negotiate special deals to maintain compliance and increase access in networks.
Seek continuous improvements by recommending changes in internal methods and procedures to Quality Assurance process.
Vendor relationship management for provider-facing technologies.
Facilitate Oral Health presentations to various educational institutions and organizations.
Assist provider offices in filing their claims electronically.
Serve as a liaison with dental offices by answering remittance payment benefit claims and eligibility questions when necessary.
Follow up with all termination letters submitted.
Represent clients and company at health fairs audits dental summits etc. throughout your designated market.
Maintain and submit all required reports. Netminder management
Assist in resolving elevated complaints and issues for clients members and providers.
Provider electronic file maintenance.
Coordinate and implement appropriate performance management strategies for team members to include:
Assist in the hiring process including interviewing candidates
Assist train and motivate team members
Evaluate and measure effectiveness of team members
Assist in preparation of performance and wage evaluations in accordance to company policy
Responsible for attendance and company approved time off for team members
Participate in the determination and implementation of Performance Improvement Plans and performance management initiatives
Other duties as assigned
What you will bring with you:
5 years experience in healthcare practice or managed care environment.
3 years supervisory/management experience
Bachelors degree in Business Healthcare Administration (or related field) or equivalent relevant experience.
Strong presentation skills.
Excellent verbal and written communication skills.
Ability to work independently and as part of a team.
Knowledge of Microsoft Office.
Proven problem-solving skills.
Problem solving and training experience.
Ability to make sound judgment conclusions based on data available with minimal supervision.
Up to 25% travel required (primarily local)
Salary:
Salary Range: $63000 - $94500
At our company we are committed to pay transparency and equity. The salary range for this role is competitive nationwide and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills qualifications experience education and geographic addition to your base salary this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.
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We are committed to fostering an inclusive environment where all employees feel they belong are supported and empowered to thrive. We are dedicated to building teams with varied experiences backgrounds perspectives and ideas that benefit our colleagues clients and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.
Life is brighter when you work at Sun Life
At Sun Life we prioritize your well-being with comprehensive benefits including generous vacation and sick time market-leading paid family parental and adoption leave medical coverage company paid life and AD&D insurance disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match stock purchase options and an employer-funded retirement account. Enjoy a flexible inclusive and collaborative work environment that supports career growth. Were proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S. weve also been recognized as a Top 10 employer by the Boston Globes Top Places to Work for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.
We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans unless the accommodation would impose an undue hardship on the operation of our business. Please email to request an accommodation.
For applicants residing in California please read our employee California Privacy Policy and Notice.
We do not require or administer lie detector tests as a condition of employment or continued employment.
Sun Life will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of applicable state and local laws including applicable fair chance ordinances.
All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or status as a protected veteran.
Job Category:
Posting End Date:
Required Experience:
Manager
Employment Type
Full-Time
