Director, Network Development

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🕒 vor 1 Monat

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $118.650 - $223.560 / Jahr

⏰ Vollzeit

🔴 Experte

👔 Direktor

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Dominion National

WebsiteLinkedInAlle Stellen

201 - 500 Mitarbeiter

Gegründet 1996

⚕️ Krankenversicherung

💸 Finanzen

👥 B2C

Healthcare Insurance • Finance • B2C

Dominion National ist Ihre vertrauenswürdige Wahl für das „Federal Employee Dental and Vision Insurance Program (FEDVIP)“. Sie bieten eine Reihe von Exklusiv-Anbieter-Organisation (EPO) Zahnplänen, die speziell für Bundesangestellte und TRICARE-Rentner entwickelt wurden. Der Fokus liegt auf kostengünstiger zahnmedizinischer Versorgung und zusätzlichen Wellness-Vorteilen. Mitglieder profitieren von Merkmalen wie Preistransparenz, flexiblen Versicherungsoptionen, Tele-Zahnmedizin-Diensten und Prämien für präventive Pflege. Dies gewährleistet optimale Mundgesundheit ohne die Last von jährlichen Höchstgrenzen oder Wartezeiten.

Beschreibung

• 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.

🎯 Anforderungen

• 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.

🏖️ Vorteile

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