Senior Manager, Provider Management, DentaQuest
Sun LifeAbout the role
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.
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: ** Candidates must be located in Oklahoma, preferred in Oklahoma City
The opportunity:
The Senior Manager, Provider Partners provides guidance and oversight to Provider Partners regarding benefit programs, policies and procedures. The position is also responsible for identifying and addressing network gaps, recognizing and implementing process improvement opportunities, and monitoring CAP performance. This position is responsible for mentoring and coaching their team in provider recruitment and engagement. In addition to managing staff, the role may also have responsibility for covering larger or more complex situations and markets.
How you will contribute:
Manage and Guide provider engagement staff
Ensure provider engagement staff recruits providers within cost and access goals
Authorize and negotiate special deals
Develop strategic action plan to address network gaps
Develop provider education curriculum and approach
Cover more markets or highly complex markets
Organize amendment and recruitment projects
Develop project plans, internal/external reports, and ensure deliverables are met
Identify and coordinate implementation of quality/cost improvements
Manage reporting process to identify and modify provider outliers
Provide cross-market support as needed
Analyze and monitor provider performance reports
Participate in and often present during client, organized dentistry and key stakeholder meetings/events
Identify continuous improvement opportunities
Manage CAP office performance
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 with 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:
Required Qualifications:
Bachelor’s degree in Business, Healthcare Administration (or related field) or equivalent, relevant experience.
5 years’ experience in healthcare practice or managed care environment.
5 years’ supervisory/management experience.
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 oversight.
Preferred Qualifications:
Supervisory/lea
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