California Senior Manager, Provider Management, DentaQuest

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/leadership experience.

• Experience in communicating with and training provider offices and customers.

• Experience in a managed care environment.