Manager, Provider Enrollment and Credentialing (DentaQuest) - Oklahoma

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 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

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:

Location: Must reside in Oklahoma

The opportunity :
The Manager, Provider Enrollment & Credentialing is responsible for managing and monitoring staff and systems that guide the accurate and timely tracking and monitoring of provider-related enrollment and credentialing activities.

How you will contribute:

• Oversee enrollment and credentialing of Providers following requirements (NCQA, CMS, DDPA, etc.).
• Collaboratively work with Quality Assurance to ensure an effective audit process, which will result in the ability to develop staff training content.
• Ensure the company’s processes meet client expectations, Federal and state regulations.
• Assist with credentialing audits as needed.
• Ensure all Applications are tracked.
• Manage staff members to ensure high-performing teams
• Complete necessary reporting to ensure staff members are completing work within the established TAT and accuracy.
• Complete necessary reporting to ensure staff members are meeting productivity requirements.
• Production of monthly staff member scorecards.
• Train and motivate team members.
• Conduct monthly one-on-one sessions for coaching and mentoring.
• Write and deliver corrective action plans when appropriate.
• Create a culture that embraces the company’s vision, mission, and goals.
• Continuously evaluate resources to ensure they are appropriately allocated to meet all Provider Operations deadlines and required outcomes.
• Implement, monitor, and maintain process changes resulting from corrective action plans.
• Identify issues and inefficiencies to make recommendations for process improvements.
• Resolve complaints and issues with providers.
• Engage and maintain relationships with internal customers to ensure provider satisfaction.
• Serve as a SME to advise our internal and external customers to proactively meet customer needs.
• Coordinate and implement appropriate performance management strategies for team members to include:
• Actively participates in the hiring process, including interviewing candidates.
• Actively participate in the preparation of performance and wage evaluations per company policy.
• Monitor and manage attendance and company-approved time off for team members.
• Update the management team timely manner on any concerns or issues.
• Other duties as assigned.

What you will bring with you:

• Bachelor’s degree in Health Care or relevant field, preferred.
• 3+ years of supervisory experience required.
• Knowledge of NCQA, URAC & CMS, and other quality requirements preferred.
• Excellent PC skills with proficiency in MS Office products.
• Excellent oral and written communication skills.
• Strong customer service and reasoning skills.
• Strong Project management and process improvement skills.
• Ability to manage staff and work well with others.
• Ability to prioritize and organize multiple tasks and remain organized with multiple interruptions.
• Ability to meet multiple deadlines.
• Ability to work more than 40 hours per week, as needed or required to meet business objectives.

Salary Range: $60,400 - $90,600

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 location. In addition to your base salary, this position is eligible for a discretionary annual incentive awa