Manager, Network Management – Performance

🕒 Agosto 22

🎰 Nevada – Remoto

🎰 Nevada – Remote

💵 $105.000 - $115.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Liberty Dental Plan

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2002

🏥 Saúde

💼 Consultoria

📦 Logística

Healthcare • Consulting • Logistics

A Liberty Dental Plan é uma fornecedora de seguros dentais com sede nos EUA, oferecendo planos dentais para Medicaid (incluindo Medi-Cal), Medicare Advantage, comercial, individual & familiar e para grupos em diversos estados. A empresa opera serviços voltados para membros (localizador de dentistas, portal do membro, aplicativo móvel, ferramentas de elegibilidade e de sinistros) e serviços voltados para prestadores (portal do provedor, inscrição na rede, envio de sinistros, diretrizes clínicas e programas baseados em valor). A Liberty Dental Plan foca na administração de benefícios dentais, gestão de rede de prestadores, conformidade e credenciamento, e atende membros, prestadores e corretores.

Descrição

• Lead targeted recruitment efforts and execute retention strategies for general dental practitioners and specialty care provider networks • Oversee provider network retention initiatives to ensure long-term stability and engagement • Review and manage provider contract documents for accuracy, completeness, and regional fee-schedule alignment • Evaluate fee increase requests and present justified proposed adjustments to Executive Leadership • Research market trends and competitor compensation structures to develop and maintain competitive provider fee schedules • Implement internal controls and oversee fee schedule addenda for assigned territories • Manage provider service initiatives and ensure timely execution of deadlines • Establish and maintain strong provider relationships • Coordinate network recruitment outreach with Provider Relations Operations staff, including mailings, fax blasts, and notifications • Develop staff performance standards and monitor productivity • Hire and train staff, conduct interviews, schedule training, and prepare instructional materials • Address employment matters with PR executive staff and Liberty's People Team, including performance-related disciplinary actions • Prepare and deliver internal and external reports on recruitment and service projects • Collaborate cross-functionally with Claims, Quality Management, Member Services, and other departments to resolve provider-related issues • Participate in Utilization Review Committees and other relevant committees • Develop and refine processes, policies, and procedures to improve network operations • Conduct weekly meetings with direct reports • Provide strategic insights and performance updates to the PR executive team • Perform other duties as assigned by executive leadership

🎯 Requisitos

• Bachelor's degree in Health Administration, Business Administration, or a related field, or an equivalent combination of education and relevant work experience • 4 to 6 years of experience in dental and/or healthcare network management, provider relations, or a related field, including prior leadership experience • Proven experience managing provider relationships and driving network performance improvements • Strong leadership, team-building, and coaching abilities with a collaborative management approach • Analytical skills for reporting and trend analysis • Knowledge of healthcare delivery systems, provider payment methodologies, and regulatory compliance • Strong problem-solving capabilities with a proactive approach to issue resolution • Knowledge of dental terminology preferred • Familiarity with government dental programs (Medicaid/Medicare) • Experience negotiating provider fee schedules • Proficiency in Microsoft Office (Word, Excel, Outlook) • Ability to work independently while achieving organizational objectives • Strong attention to detail and well-developed organizational skills • Excellent customer service orientation • Proficient written and verbal communication • Ability to present to diverse audiences and negotiate effectively • Ability to analyze problems, gather relevant data, establish facts, and draw valid conclusions • Experience conducting thorough research and ensuring issue resolution • Must be willing and able to travel up to 50% • Must live and work in the United States; Liberty is unable to hire or allow employees to work outside the United States • No relocation assistance or sponsorship available at this time

🏖️ Benefícios

• Competitive pay structure and savings options • 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines • Affordable medical insurance with low-cost premiums for employee-only coverage; Liberty subsidizes eligible dependents' coverage • 100% employer-paid dental coverage for employees and eligible dependents • Vision insurance with low-cost premiums for employee-only coverage and dependents • Company-paid basic life and AD&D insurance equal to one times base salary, with options to purchase supplemental coverage • Flexible Spending Accounts for healthcare and dependent care expenses • Voluntary accident, critical illness, and hospital indemnity insurance • Long-term disability coverage • Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts • Employee Assistance Program (EAP) supporting mental health and well-being • Generous vacation and sick leave policies, with unused time rollover • 10 paid company holidays • Tuition reimbursement for eligible educational expenses • Remote or hybrid work options available for various positions