Director, Network Development

Job not on LinkedIn

🕒 May 7

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $118.7k - $223.6k / year

⏰ Full Time

🔴 Lead

👔 Director

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Dominion National

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1996

⚕️ Healthcare Insurance

💸 Finance

👥 B2C

Healthcare Insurance • Finance • B2C

Dominion National is your trusted choice for the Federal Employee Dental and Vision Insurance Program (FEDVIP). They offer a range of Exclusive Provider Organization (EPO) dental plans specifically designed for federal employees and TRICARE retirees, focused on providing cost-effective dental care and additional wellness benefits. Members enjoy features such as price transparency, flexible coverage options, tele-dentistry services, and rewards for preventive care, ensuring optimal oral health without the burden of annual maximums or waiting periods.

📋 Description

• Effectively lead and manage recruitment and administration team. • Develop recruitment plan with leadership and sales to target and prioritize recruitment areas including expansion opportunities. • Direct Provider Development Managers and staff to meet targeted recruitment goals. • Act as liaison between Network Development and various Dominion administrative departments. • Responsible for provider compliance with state and federal regulations. • Oversees complaint processes and procedures. • Maintain current knowledge of industry and technical issues through participation in seminars, workshops and publications. • Identify and recruit providers as necessary to ensure the development of a provider network compliant with CMS network adequacy and other entity requirements. • Coordinate with Actuarial, Finance and the Senior Team the review and development of provider fee schedules that will help ensure the growth of Dominion National’s provider network. • Ensure provider demographic and rate related information is captured and properly loaded in all Dominion systems consistent with company policy. • Recruit, manage/oversee the training of new employees, as well as developing and applying appropriate policies and procedures for Network Development activities, including compliance. • Direct the ongoing operations of the Provider Network, including the development of reports to measure the overall functioning of the department to ensure adherence to all performance metrics. • Participate in the evaluation, recruitment, and management of vendors for specialized services. • Participate and represent department in cross-functional standing committees as requested. • Monitor daily performance of staff to ensure adherence to all performance metrics and promptly identify necessary corrective actions. • Build strong relationships with providers. • Performs other duties as assigned.

🎯 Requirements

• Understanding of and relevant experience in commercial and Medicare populations and lines of business. • Proven effective communications skills (verbal, written, presentation) with all types and levels of audiences. • Proficiency with MS Office applications (word processing and database/spreadsheet). • Excellent analytic, interpersonal, project management, negotiation and leadership skills. • Critical thinking, problem-solving and collaborative team-player mindset. • Confidence in taking ownership of work processes with only high-level direction and guidance; • Ability to lead people and inspire them to do their best. • Knowledge of reimbursement principles and state and federal Medicare/Medicaid financing rules and regulations. • Minimum 7 years of dentist recruitment focused in the Group Health/Dental fields necessary. • Minimum 3 years of leadership experience at a health plan. • Proven ability to effectively manage in a matrix organization. • Previous experience with implementation and expansion of a health plan business unit or division.

🏖️ Benefits

• Medical, Dental & Vision coverage • Retirement Plan • Generous time off including Paid Time Off, Holidays, and Volunteer time off • Incentive Plan • Tuition Reimbursement • and more.